Presentation
Presternal lump for 5 days with no fever. No skin inflammation.
Patient Data
There is an anterior chest wall soft tissue opacification with a central hypodense component and peripheral enhancement. Soft tissue edema and skin thickening adjacent to this lesion.
There seems to be a fistulous tract communicating between the sternal bone and the hypodense component.
Lungs and pleural spaces are clear.
Unremarkable chest x-ray.
There is a hypoechoic collection in the presternal region with an adjacent soft tissue edema.
The soft tissue mass/collection is hypointense on T1, and heterogenous on T2, with marked enhancement after contrast injection.
The fistulous tract connecting the soft tissue mass/collection and the sternal bone is seen on STIR images.
Case Discussion
The main differential diagnosis for this lesion was a neoplastic lesion involving the bone and soft tissues with a central necrotic component. The puncture and biopsy of the lesion demonstrated granulomatous inflammation, and neoplastic cells were seen.
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