Presentation
Dyspnea and mediastinal mass on chest X-ray
Patient Data
A large middle mediastinal mass is visible in the right paratracheal space. The majority of mass has fat density except for a calcified component, anteriorly, and a small soft tissue component superiorly. The mass displaces the SVC anteriorly and insinuates to the azygoesophageal recess.
The first photo is the pathology report of a biopsy specimen. The second shows the pathology report of resected mass.
Case Discussion
The patient underwent a biopsy that shows mature adipose tissue. Then he underwent mediastinal mass resection. On histopathologic evaluation, the mass shows mature fat, woven bone, and nerve trunks without any atypia. The pathologist suggests mature teratoma initially, but on further evaluation, lipoma with metaplastic bone formation is proposed.