Tan Poh Yong, Tham Wei Ping, Yong Yan Rong
Department of Internal Medicine, Singapore General Hospital, Singapore.
Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Singapore Med J. 2019 Jan;60(1):17-21. doi: 10.11622/smedj.2019005.
A 68-year-old woman presented with weight loss of 7 kg over two years. Clinical examination revealed no specific abnormality and the patient was otherwise asymptomatic. Chest radiography performed to screen for malignancy revealed a soft tissue opacity projected over the mediastinum. Computed tomography of the thorax showed an enhancing anterior mediastinal mass with heterogeneous enhancement and contrast pooling in the arterial phase, followed by homogeneous enhancement in the venous phase, consistent with an aneurysm arising from the superior vena cava. This case highlights superior vena cava aneurysms as extremely rare causes of anterior mediastinal masses. Other causes of anterior mediastinal masses were also discussed.
一名68岁女性,两年来体重减轻了7公斤。临床检查未发现特异性异常,患者无其他症状。为筛查恶性肿瘤而进行的胸部X线检查显示,纵隔有一软组织密度影。胸部计算机断层扫描显示前纵隔有一强化肿块,增强不均匀,动脉期有造影剂聚集,静脉期呈均匀强化,符合上腔静脉动脉瘤表现。该病例凸显了上腔静脉动脉瘤是前纵隔肿块极为罕见的病因。文中还讨论了前纵隔肿块的其他病因。