Mediastinal hemangioma mimicking an invasive tumor growth: A case report

Successful surgical management of capillary hemangioma of the anterior mediastinum with recurrent pleural effusion

We report a case of a 73-year-old male, presenting with persistent cough and shortness of breath. He was diagnosed with an anterior mediastinal mass with significant recurrent loculated pleural effusion. The pre-operative biopsy from the mass was inconclusive. The patient underwent video-assisted thoracoscopic decortication on the left side followed by anterolateral thoracotomy for radical mediastinal mass excision, with notable challenges including mass being densely adherent to critical mediastinal structures intra-operatively and atrial fibrillation postoperatively. Final histopathology was suggestive of "capillary hemangioma." This case highlights the complexity of diagnosing and managing such rare mediastinal mass and the importance of a multidisciplinary approach.

Rare posterior mediastinal hemangiomas invading the spinal cord through the intervertebral foramen and causing acute symptoms: illustrative case

BACKGROUND

Hemangioma is a rare vascular tumor characterized by endothelial cell proliferation that primarily occurs in soft tissues. While most cases in the paraspinal posterior mediastinum are clinically indolent, they can also exhibit aggressive growth, leading to severe clinical outcomes and necessitating urgent treatment.

OBSERVATIONS

A 61-year-old right-handed female presented with reduced lower-extremity mobility that had begun 4 days earlier. An examination revealed that both lower limbs had grade 4 muscle strength. Computed tomography and magnetic resonance imaging revealed a right T1-3 paravertebral dumbbell-shaped soft tissue mass invading the spinal canal, destroying the T2 vertebra, and compressing the spinal cord and nerve roots. Elective surgery was planned, but a rapid muscle strength decline prompted emergency surgery. Postoperative muscle strength improved to grade 4, and at the 3-month follow-up, muscle strength had fully recovered.

LESSONS

Postoperative pathological examination revealed that the mediastinal dumbbell-shaped lesion was a hemangioma. While most hemangiomas progress slowly, acute symptoms of spinal cord compression are exceedingly rare. This case demonstrates the aggressive behavior of hemangioma, which invaded through the intervertebral foramen and compressed the spinal cord, resulting in acute symptoms. This case also shows that surgical removal of the tumor and restoration of spine stability via a posterior approach has proven beneficial. https://thejns.org/doi/10.3171/CASE24485.

Mediastinal Hemangioma Masquerading as a Simple Cyst

ABSTRACT

This report presents imaging from a mediastinal mass in a patient with colon cancer. At baseline and surveillance chest computed tomography examinations, it was characterized as a pericardial cyst. However, during chemotherapy, complications arose and this mass was further characterized with a chest MRI. It was then decided to be removed, and histopathology confirmed the diagnosis of a hemangioma.

Cavernous mediastinal hemangioma presenting with persistent cough: a rare case report and review of literature

BACKGROUND

Cavernous hemangioma is a rare benign tumor which can sometimes mimic the clinical presentation and radiological findings of malignant tumors. Here we present a rare presentation of cavernous hemangioma in the mediastinum (CHM), along with a literature review among the main databases.

CASE PRESENTATION

We present a 48-year-old male who had suffered from persistent cough as the sole symptom of an anterior CHM. Computed tomography scan demonstrated a 12.5 × 10.8 cm mass in the anterior mediastinum. The mass was surgically resected, and histopathological evaluation established the diagnosis of CHM. The patient was discharged in good condition, in which during his four-month follow-up period, no recurrence of the tumor has been observed.

CONCLUSION

Although cavernous hemangioma rarely present in the mediastinum, it should be considered in the differential diagnosis of mediastinal tumors. However, our review of literature demonstrated a female dominance and average age of 40 years, with a 52% mortality rate based on previous reports.

A case report of mediastinal cavernous hemangioma

When faced with a hypervascular mediastinal tumor, mediastinal hemangioma should be taken into consideration. Although it is uncommon, considering this important diagnosis may avoid a possible extensive surgery that is not necessary.