J Korean Soc Radiol.  2016 Aug;75(2):147-150. 10.3348/jksr.2016.75.2.147.

Primary Mediastinal Leiomyoma Mimicking a Giant Mediastinal Cyst: A Case Report

• Hwang YU
• Kim SY
• Lee BH
• Hwang YJ
• Lee JY
• Kim YS
• Kim HS

• KMID: 2344806
• DOI: http://doi.org/10.3348/jksr.2016.75.2.147

Abstract

Primary mediastinal leiomyoma is an extremely rare benign tumor of smooth muscle. Most common radiographic appearance is a well circumscribed heterogeneous solid mass. We reported a case of giant cyst-like lesion at the middle mediastinum, which was pathologically confirmed as a primary mediastinal leiomyoma.

MeSH Terms

Leiomyoma*
Mediastinal Cyst*
Mediastinal Neoplasms
Mediastinum
Muscle, Smooth

Figure

• 

  Fig. 1 Primary mediastinal leiomyoma in a 58-year-old male patient. A. Chest radiography shows a huge left retrocardiac soft tissue mass. B, C. Axial precontrast (B) and postcontrast CT image (C) show a well defined, huge, thin-walled, homogenous low attenuated mediastinal mass. Mediastinal mass shows attenuation of values of 10–30 HU (pre-contrast) and 10–30 HU (post-contrast), respectively. The mass is in close contact with the esophagus (arrow). D. Coronal enhanced CT reconstruction shows the mediastinal mass without internal enhancing solid component or inner wall irregularity in left posterior mediastinum. Smaller bronchi (arrows) are upward laterally displaced by the mass. E. Photograph of the gross specimen shows softly flesh and mucoid cut surface with hemorrhage in the inner wall. F. Desmin immunohistochemistry reveals strong positive for spindle tumor cells (× 100). G. The light microscopic feature of tumor shows microcystic changes between slender neoplastic tumor cell clusters. Mucin materials are noted in the microcysts. These are consistent with leiomyoma with microcystic change (hematoxylin-eosin, × 100). CT = computed tomography, HU = Hounsfield unit

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