Posterior mediastinal mass - probable oesophageal carcinoma

Case contributed by RMH Core Conditions

Presentation

Three days flu-like symptoms ?pneumonia.

Patient Data

Age: 44
Gender: Male

Heart size is within normal limits. Posterior mediastinal density on lateral projection. CT chest recommended.

There is impression of a mid oesophageal lesion, measuring 4 x 3 cm in axial diameter, extending over a 4 cm segment just above the level of the carina. The oesophagus both above and below this region is mildly dilated, and there is debris within the lumen, possibly a trapped food bolus. No mediastinal, hilar or axillary lymphadenopathy is demonstrated. No suspicious osseous lesions. A small hiatus hernia is noted in the lower oesophagus.

Patchy airspace opacity is seen within the superior lingula segment of the left upper lobe, with very mild change in the posterior segment of the right upper lobe. Multiple small pulmonary nodules are seen in both lungs, none larger than 5 mm in diameter.

Old left rib fractures noted. The visualised upper abdominal viscera are within normal limits.

Conclusion:

Partial obstruction of the mid oesophagus, suspicious for a primary oesophageal carcinoma. Correlation with gastroscopy is suggested.

Case Discussion

The patient had a psychiatric history and refused any further investigations. 

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Case information

rID: 30179
Case created: 23rd Jul 2014
Last edited: 10th Sep 2015
Inclusion in quiz mode: Included

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