Presentation
Chest pain and dyspnea.
Patient Data
There is a 90 x 100 x 170 mm huge multilobulated solid necrotic mass lesion with heterogenous enhancement infiltrating the superior, anterior and middle mediastinum.
The mass shows irregular interface with the adjacent medistinal structures including great vessels and pushes them posteriorly.
No evidence of calcification.
Bilateral moderate pleural effusion.
Hypodense lesion measuring about 15 mm along with left liver lobe segment II.
IHC report was compatible with mediastinal high grade spindle cell sarcoma.
Case Discussion
The patient went on to have biopsy of the mediastinal mass. The histopathological exam with immunochemistry confirmed the diagnosis of a mediastinal high-grade spindle cell sarcoma.