Anterior mediastinal leiomyosarcoma mimicking thymoma: A case report.

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.