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Primary mediastinal embryonal carcinoma masquerading as chronic pancreatitis
Mahazarin Kaikobad1, Yee Chung Cheng, Hongyung Choi
1Division of Neoplastic Diseases and Related Disorders, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
WMJ : Official Publication of the State Medical Society of Wisconsin
|September 12, 2007
Summary
Primary mediastinal embryonal cell carcinomas, aggressive tumors, can occur in older adults. This case highlights the importance of considering mediastinal masses in the differential diagnosis of unexplained epigastric pain.
Area of Science:
- Oncology
- Diagnostic Imaging
Background:
- Primary mediastinal embryonal cell carcinomas are aggressive cancers typically diagnosed in younger adults (20-50 years).
- These tumors often present with pulmonary symptoms or signs of local compression.
Observation:
- A 72-year-old male patient presented with intractable epigastric pain, initially misdiagnosed as chronic pancreatitis.
- Diagnostic delay occurred due to the atypical presentation and patient's age.
Findings:
- A chest computed tomography (CT) scan revealed a mediastinal mass, leading to the diagnosis of embryonal cell carcinoma.
- This case demonstrates that embryonal cell carcinoma can manifest in older individuals.
Implications:
- Mediastinal tumors should be considered in the differential diagnosis of persistent epigastric pain, even in elderly patients.
- Early and thorough investigation, including advanced imaging, is crucial for diagnosing rare presentations of mediastinal embryonal cell carcinoma.
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