Mediastinal lipoma with metaplastic bone formation

Case contributed by Assis Prof Faeze Salahshour

Presentation

Dyspnea and mediastinal mass on chest X-ray

Patient Data

Age: 65 years
Gender: Male

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.

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Case information

rID: 82347
Published: 29th Sep 2020
Last edited: 8th Oct 2020
System: Chest
Inclusion in quiz mode: Included
Institution: Tehran University of Medical Sciences (TUMS)