What is the differential diagnosis for an anterior mediastinal mass?
Thyroid carcinoma, thymoma, teratoma, lymphoma and thoracic aortic aneurysm.
The heart is enlarged. There is a pericardial drain in situ. There is a small residual pericardial effusion measuring up to 1.9 cm in depth. There is a large lobulated mass in the anterior mediastinum, measuring 8.6 x 6.7 x 6.6 cm (transverse by AP by caudocranial dimensions). It is composed mainly of material of soft tissue density with small foci of calcification centrally measuring up to 1.2 cm. The mass probably invades the anterosuperior pericardium, and is closely related to the deepest pocket of the pericardial effusion. The mass also abuts the anterior surface of the left brachiocephalic vein, but does not cause significant compression.
There are small bilateral pleural effusions with minimal bibasal compressive atelectasis.