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Spontaneous mediastinal hematoma presenting as a mass

Mitsuhiro Kamiyoshihara1, Takashi Ibe, Seiichi Kakegawa

  • 1Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan. m-kamiyoshihara@maebashi.jrcor.jp

Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
|June 5, 2007
PubMed

Insights

A spontaneous mediastinal hematoma resolved on its own in a patient undergoing hemodialysis. This rare condition presented as a mediastinal mass, highlighting the importance of imaging follow-up for resolving lesions.

Area of Science:

  • Cardiology
  • Radiology
  • Nephrology

Background:

  • A 59-year-old male on long-term hemodialysis for chronic renal failure presented with back pain.
  • The patient had a history of brain infarction and was on daily aspirin therapy.

Observation:

  • Imaging revealed an upper mediastinal mass near major vessels and the trachea.
  • The mass showed a slight decrease in size on follow-up magnetic resonance imaging.
  • The patient's symptoms gradually resolved concurrently with the mass reduction.

Findings:

  • The mediastinal mass completely resolved on subsequent imaging.
  • The clinical presentation and imaging characteristics were consistent with spontaneous mediastinal hematoma.

Implications:

  • Spontaneous mediastinal hematoma is a rare entity that can mimic other mediastinal pathologies.
  • Conservative management with close imaging surveillance may be appropriate for resolving mediastinal masses.
  • Understanding the natural history of such hematomas is crucial for accurate diagnosis and patient management.

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