On PET scan, there is an intensely FDG avid, large mass lesion in the anterior mediastinum. On low dose CT, the lesion is generally homogenous in density with several foci of course calcification. No fat density is seen within the lesion.
The avidity of the large mass is contiguous with a rounded extrapleural lesion at the right lung apex, which may reflect a large supraclavicular lymph node or direct extension from the primary tumour.
The large mass compresses the superior vena cava, resulting in the patient's clinical symptoms and signs.
No additional FDG avid nodal or metastatic disease was identified. In particular, no second hypermetabolic primary lesion was identified in the testes. No pulmonary lesions were demonstrated on review of the lung windows (not shown).