Medistinal lymphatic malformation

Case contributed by Dr Hisham Alwakkaa

Presentation

Chest pain and difficulty breathing.

Patient Data

Age: 11 years
Gender: Male
X-ray

Large anterior mediastinal mass, best appreciated on the lateral view. On the frontal view it gives the illusion of cardiomegaly.

Lungs are clear with no evidence of pulmonary congestion.

There is a large, multiloculated, non-enhancing cystic mass of fluid-attenuation centered on the anterior mediastinum, asymmetric to the left side. It causes displacement of the adjacent airways and vascular structures without evidence of compression.

No other significant findings are appreciated.

X-ray

Unremarkable chest radiograph with no evidence of recurrence on 8 years follow-up study.

 

 

Case Discussion

This is a case of histologically-confirmed mediastinal lymphatic malformation.

Patient first presented with chest pain and difficulty breathing, and a mediastinal mass was detected on chest radiograph and CT. After that, the patient underwent a draining procedure and had a Chamberlain procedure to biopsy the wall, which was positive for lymphatic malformation. However, the cyst kept recurring despite multiple draining and sclerotherapy procedures with doxycycline and the patient continued to be symptomatic. Because of that, the decision was made to excise the lesion thoracoscopically. The procedure was successful, and most of the cyst was removed and the patient has had no recurrence on 8 years follow-up chest radiograph.

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Case information

rID: 60988
Published: 12th Jun 2018
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included
Institution: Women and children Hospital of Buffalo

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