Anterior mediastinal mass causing phrenic and recurrent laryngeal nerve dysfunction
Presentation
Known non-Hodgkins lymphoma with hoarseness.
Patient Data
Large anterior mediastinal mass with elevation of the left hemidiaphragm.
Large heterogeneous anterior mediastinal mass with manubrial destruction and chest wall invasion encasing the aortic arch and aortic branch vessels. Occlusion left internal jugular and left brachiocephalic veins, narrowing right brachiocephalic vein. Compression and narrowing of the trachea, bilateral pleural effusions. No neck lymphadenopathy. Paralyzed left vocal cord.
Case Discussion
This case shows that masses compressing nerves may compromise the functions of those nerves. The anterior mediastinal mass compresses both the left recurrent laryngeal and phrenic nerves. Although the nerves themselves are not visible on the CT scan, we can infer that they are not functioning because the left vocal cord and the left hemidiaphragm are both paralyzed.