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Title: Een 76-jarige vrouw met een anterieure mediastinale massa
Author(s): BEHAEGEL M, SPINCEMAILLE K, DEMETTER P, SMEETS P, JOOS G
Journal: Tijdschrift voor Geneeskunde
Volume: 60    Issue: 16   Date: 2004   
Pages: 1162-1166
DOI: 10.2143/TVG.60.16.5001945

Abstract :
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Anterior mediastinal mass
A 76-year-old woman consulted because of weight loss (8 kg in 2 months) and fatigue. She suffered from dyspnea (NYHA 2). She was known with a multinodular goiter with autonome function and subclinical hyperthyreoidism. She never smoked. Clinical examination revealed an enlarged thyroid without souffle or thrill. Heart and lung ausculation were normal. RX thorax and CT thorax revealed a hypodense mass with calcifications in the anterior mediastinum. There was no evidence of invasion in other organs or of enlarged adenopathies.
The differential diagnosis of masses of the anterior mediastinum includes cervical goiter extending into the mediastinum, germ-cell tumors, masses originating from the thymus, and lymphoma.
Echo-guided biopsy revealed thyroid tissue.
Since malignancy could not be ruled out definitively (carcinoma is identified in 1% of the cases), the mass was removed at the same time of a subtotal thyroidectomy and a coronary arterial bypass grafting (CABG) because of two vessel disease.
Pathological evaluation confirmed the preoperative diagnosis of ectopic mediastinal thyroid tissue without malignancy.

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