Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
The patient was an eleven year old male with upper respiratory symptoms and wheezing who had a past medical history remarkable for esophageal atresia and tracheoesophageal fistula, repaired in infancy.
Clinical Physical Exam:
Clinical Differential Diagnosis:
Chest film showed a superior mediastinal mass. A barium swallow (not provided) showed the esophageal anastomosis to be widely patent, and the mass was noted to be retrosternal in position. A chest CT exam showed a cystic structure in the anterior mediastinum.
Images 1 and 2
Imaging Differential Diagnosis:
The patient was taken to the operating room electively several days later. A cystic mass was removed from the anterior mediastinum.
Pathological examination of the mass revealed findings characteristic for a thymic cyst.
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course. Post operatively his wheezing disappeared, apparently the cyst had pushed the great vessels against the trachea and caused the wheezing.
Case 33, Case 37, Case 38, Case 39, Case 40, Case 41, Case 60
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