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Anterior mediastinal leiomyosarcoma mimicking thymoma: A case report

Xing Xue¹, Wenjie Liang, Wenjuan Zhang

¹Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Department of Anesthesiology, the First People's Hospital of Taicang City, Taicang Affiliated Hospital of Soochow University, Taicang, Suzhou, China.

|June 21, 2018

Abstract

Rationale:

Mediastinal leiomyosarcoma is very rare. In this paper, we report one case of anterior mediastinal leiomyosarcoma and retrospectively review the imaging findings of previously reported cases.

Patient Concerns:

A 61-year-old male patient was admitted to our hospital due to the presence of a mediastinal space-occupying lesion for two years. Two years previously, chest computed tomography (CT) showed a small nodule in the anterior mediastinum. Twenty days previously, the CT examination was repeated at the local hospital due to respiratory symptoms, which showed a mass in the anterior mediastinum and interstitial inflammation of both lungs. After admission to our hospital, chest contrast-enhanced CT scanning showed a mass in the right anterior mediastinum that was approximately 3.3 × 5.2 cm2 in size that had a clear boundary, slightly heterogeneous internal density and heterogeneous enhancement.

Interventions:

The patient underwent a mediastinal lump resection.

Diagnoses:

Finally, the pathological diagnosis was anterior mediastinal leiomyosarcoma.

Outcomes:

The patient recovered well after the operation.

Lessons:

Accidental discovery of anterior mediastinal nodules should be followed up. Mediastinal leiomyosarcoma is common in the posterior mediastinum. Imaging shows a heterogeneous mass with a space-occupying effect that may easily involve adjacent mediastinal vessels or infiltrate surrounding organs.

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