Mediastinal mass in the elderly with complaints of weight loss, nausea and vomiting

Document Type : Case Study

Authors

1 Assistant, Department of internal medicine, Assistant Professor of Internal medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Residence of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: The prevalence of mediastinal masses is variable. These lumps can be diagnosed accidentally on a CT scan or chest x-ray and can range from benign to malignant.
Introduction of the patient: The patient was a 74-year-old man without a history of previous illness who had referred to the emergency department of Ghaem Hospital in Mashhad with a complaint of nausea and vomiting. Chest flattening of the mediastinum was observed and then a CT scan of the chest was requested for the patient. Finally, the necessary treatments were started for the patient with a diagnosis of lymphoma.
Conclusion: Mediastinal masses can be diagnosed accidentally in people who undergo imaging evaluations for other reasons such as CT scan or chest radiograph and can be a good cause. ‌ Malignant such as substernal thyroid to malignant causes such as lymphoma, thymus cancer and germ cell masses. With proper history and physical examination and evaluation of signs and symptoms related to the mass, the correct diagnosis can be achieved for the patient.

Keywords

References

  1. Alibhai SM, Greenwood C, Payette H. An approach to the management of unintentional weight loss in elderly people. CMAJ 2005; 172:773.
  2. Bouras EP, Lange SM, Scolapio JS. Rational approach to patients with unintentional weight loss. Mayo Clin Proc 2001; 76:923.
  3. Lardinois D, Weder W. Diagnostic strategies in mediastinal mass. In: Pearson's Thoracic & Esophageal Surgery, 3rd ed, Patterson GA, Pearson FG, Cooper JD, et al (Eds), Churchill Livingstone, Elsevier, Philadelphia 2008. Vol 1, p.1506.
  4.  Shields TW. Overview of primary mediastinal tumors and cysts. In: General Thoracic Surgery, 6th ed, Shields TW, LoCicero III J, Ponn RB, Rusch VW (Eds), Lippincott Williams & Wilkins, Philadelphia 2005. Vol 2, p.2489.
  5. Kitami A, Sano F, Ohashi S, et al. The Usefulness of Positron-Emission Tomography Findings in the Management of Anterior Mediastinal Tumors. Ann Thorac Cardiovasc Surg 2017; 23:26.
  6. Kawahara K, Miyawaki M, Anami K, et al. A patient with mediastinal mature teratoma presenting with paraneoplastic limbic encephalitis. J Thorac Oncol 2012; 7:258.
  7. Vierboom YC, Preston SH, Stokes A. Patterns of weight change associated with disease diagnosis in a national sample. PLoS One 2018; 13:e0207795
  8. Vanderschueren S, Geens E, Knockaert D, Bobbaers H. The diagnostic spectrum of unintentional weight loss. Eur J Intern Med 2005; 16:160
  9. Marton KI, Sox HC Jr, Krupp JR. Involuntary weight loss: diagnostic and prognostic signi!cance. Ann Intern Med 1981; 95:568.
  10. Metalidis C, Knockaert DC, Bobbaers H, Vanderschueren S. Involuntary weight loss. Does a negative baseline evaluation provide adequate reassurance? Eur J Intern Med 2008; 19:345
  11. Su S, Colson YL. Overview of benign and malignant mediastinal diseases. In: Adult Chest Surgery, 2nd ed, Sugarbaker DJ, Bueno R, Colson YL, et al (Eds), McGraw-Hill Education, New York 2015. p.1234.
  12. Puc HS, Heelan R, Mazumdar M, et al. Management of residual mass in advanced seminoma: results and recommendations from the Memorial Sloan-Kettering Cancer Center. J Clin Oncol 1996; 14:454.
  13. Bruno P, Ricci A, Esposito MC, et al. Efficacy and cost effectiveness of rapid on site examination (ROSE) in management of patients with mediastinal lymphadenopathies. Eur Rev Med Pharmacol Sci 2013; 17:1517.
Navid No
Volume 24, Issue 80
March 2022
Pages 81-88

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