Teratoma of the anterior mediastinum presenting as a cystic neck mass: a case report

<p>Abstract</p> <p>Introduction</p> <p>Teratomas of anterior mediastinum are rare tumors and are often slow growing, asymptomatic and detected incidentally on chest imaging. Results of surgical resection are very satisfactory.</p> <p>Case presentation</p> <p>A 19-years old male presented with an asymptomatic cystic neck mass. X-ray and CT scan of chest and neck showed an extrathyroidal multi-septate, predominantly cystic neck mass, that was continuous with a solid intrathoracic mass extending up to the level of right atrium and which contained areas of calcification and cystic necrosis. The mediastinal structures did not show any features of compression or infiltration. Fine needle aspiration cytology from the neck mass was suggestive of a dermoid cyst. In view of the extent and uncertain pathological nature of the tumor, it was excised via a combined cervical and trans-sternal route. Histo-pathology of the resected specimen confirmed the diagnosis of a mature cystic teratoma. The patient made an uneventful recovery, and after five years of follow-up, he has been symptom free with no clinical or radiological evidence of recurrent disease. We discuss the role of imaging and the need for surgical treatment to avoid possible catastrophic complications in patients with cervical and mediastinal masses of uncertain histological nature.</p> <p>Conclusion</p> <p>A mediastinal teratoma may rarely present as a cystic neck swelling due to its cephalad extension. This entity needs to be considered in cases where clinical and investigative work-up fail to provide a convincing clue to a primary neck pathology as cause of a cystic neck swelling.</p

Contribution of magnetic resonance imaging in the diagnosis of talus skip metastases of Ewing's sarcoma of the calcaneus in a child: a case report

<p>Abstract</p> <p>Introduction</p> <p>Ewing's sarcoma of the calcaneus is rare. About thirty cases with calcaneus involvement have been reported in the literature. Talus skip metastases have rarely been described in the available literature</p> <p>Case presentation</p> <p>We report a case of a 14-year-old Moroccan boy, who presented with Ewing's sarcoma of his right calcaneus, diagnosed by swelling of the calcaneus evolving over a year. Radiography, computed tomography and magnetic resonance imaging showed an important tumoral process of the calcaneus and talus skip metastases. The diagnosis was confirmed with histology after a biopsy. In spite of amputation and postoperative chemotherapy, our patient died six months later due to secondary respiratory distress after lung metastasis.</p> <p>Conclusion</p> <p>Imaging, especially magnetic resonance, is important in the diagnosis of Ewing sarcoma and skeletal skip metastases. Treatment of Ewing's sarcoma consists of chemotherapy, radiation therapy and surgical resection depending on the stage and extent of the disease. With the exception of lesions in the calcaneus, the prognosis for disease-free survival of Ewing's sarcoma of the foot is excellent.</p