Caceres’s Corner Case 60 (Update: Solution)


Dear Friends,

Today, we’re showing you radiographs of a 29-year-old non-European male with moderate dysphagia. Questions:

1. Where is the lesion?
2. What would be your diagnosis?

29-year-old, PA chest

29-year-old, PA chest

29-year-old, lateral chest

29-year-old, lateral chest

Click here for the answer to case #60

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    Mar 2013
    DISCUSSION 17 Comments

    17 Responses to : Caceres’s Corner Case 60 (Update: Solution)

    1. Xose says:

      Medium mediastinum mass. No lymph node enlargement or other finding pointing at traction diverticulum.
      The dysphagia suggests primary a esophageal disease. May be a GIST ?

    2. dr ashraf abohadeed says:

      chest x ray frontal and lateral views.
      A large well defined lobulated mass is seen subcarinal in location and extend into azygoesophageal recess with normal carinal angle .
      normal lungs and cardiac shadow.
      no pleural effusion.
      normal underlying ribs and vertebrae .
      subcarinal mass extending into azygoesophageal recess .
      DD: enlarged lymphnode either inflmmatory or neoplastic .
      bronchogenic cyst .
      esophageal mass , for ct scan with oral and IV contrast

    3. gus says:

      there is a subcarinal mass.there is not normal carinal angle.
      the mass desplace esophagus in lateral view and produse depression and dilatation of esophagus.i think that is external pressure.

    4. gaborini says:

      bronchogenic cyst this time

    5. Gkagkanasiou Maria says:

      middle mediastinum lesion with discrete borders . If not a congenital mass, i would think of infectious disease( non european male).

    6. Vera Daskalovska says:


    7. sahar ahmed says:

      Leomyoma of the esophagus , aberent lt pulmonary artey is another possibility


      Location: Medium Mediastinal space
      Diagnostic: Broncogenic vs pericardial cist

    9. genchi bari italia says:

      Opacità ovoidale nel mediastino medio, al di sotto della carena tracheale che non sembra improntata.Nessuno ha pensato alla M. di Castleman nella DD ? Io lancio questa opzione.

    10. Alberto Montemayor Martinez says:

      bronchogenic cyst

    11. Ricardo Macareno says:

      1/ Middle mediastinum.

      2/Foregut duplication cyst (esofaphageal, bronchogenic) or lymphadenopathy.

    12. Alice says:

      there is an oval slightly lobulated mass in the lower middle mediastinum with close contact to the posterior mediastinum.
      no other abnormalties.
      1 duplication cyst
      2 lymphadenopathy (anamnesis could be misleading though)
      3 oesphageal mass (protruding in the middle med. from posterior) – diverticulum?
      contrast could be given during repetition of the lateral view to gain more information of the position of the oesophagus, although ct is necessary.

      • jose caceres says:

        Correct discussion. Just a little correction: the mass is in the middle part of the middle mediastinum. Masses in the lower part are lower(of course!) and have a different origin.

    13. jose caceres says:

      Good. Many of you are following the correct approach to mediastinal masses: first, place it in the correct compartment and second, mention the most common etiologies in this location. The following step is an enhanced CT, which will be shown next Tuesday.
      Have a nice vacation!

    14. muneesh sharma says:

      1. middle mediastinum subcarinal
      2. bronchogenic cyst

    15. dr rajive bhatnagar says:

      Pretracheal mass could be lymphadenopathy with minimal cp angle blunting
      anteriorly side?.