Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge

Detalhes bibliográficos
Autor(a) principal: Martins,Cláudio
Data de Publicação: 2017
Outros Autores: Sousa,Paula, Araújo,Tarcísio, Castro-Poças,Fernando, Pedroto,Isabel
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000400007
Resumo: The differential diagnosis of mediastinal masses involves many benign and malignant conditions, such as lymphadenopathies and cystic lesions. Metastatic mediastinal adenopathies are usually due to lung, esophagus, and stomach cancer and, rarely, due to colorectal cancer. Gastrointestinal duplication cysts are uncommon inherited lesions usually diagnosed during childhood and may involve the esophagus in 20% of cases. In adults, they are usually asymptomatic and diagnosed incidentally. We report the case of a 54-year-old male who recently underwent sigmoidectomy due to an obstructive colon adenocarcinoma. Staging computed tomography scan showed a hypodense lesion in the posterior mediastinum suggestive of metastatic adenopathy. Endoscopic ultrasound revealed a homogeneous and hypoechogenic lesion with intramural location in the upper esophagus, suggestive of a duplication esophageal cyst. Given the oncologic background and to exclude metastatic disease, endoscopic ultrasound-guided fine needle aspiration was performed, and a mucinous fluid was aspirated. The cytologic examination supported the ultrasonographic diagnostic hypothesis. This case highlights the role of endoscopic ultrasound in the differential diagnosis of mediastinal masses, particularly in oncologic patients, in order to rule out more ominous lesions.
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spelling Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic ChallengeEndosonographyEsophageal cyst, diagnosisColorectal neoplasmsLymphatic metastasisMediastinumThe differential diagnosis of mediastinal masses involves many benign and malignant conditions, such as lymphadenopathies and cystic lesions. Metastatic mediastinal adenopathies are usually due to lung, esophagus, and stomach cancer and, rarely, due to colorectal cancer. Gastrointestinal duplication cysts are uncommon inherited lesions usually diagnosed during childhood and may involve the esophagus in 20% of cases. In adults, they are usually asymptomatic and diagnosed incidentally. We report the case of a 54-year-old male who recently underwent sigmoidectomy due to an obstructive colon adenocarcinoma. Staging computed tomography scan showed a hypodense lesion in the posterior mediastinum suggestive of metastatic adenopathy. Endoscopic ultrasound revealed a homogeneous and hypoechogenic lesion with intramural location in the upper esophagus, suggestive of a duplication esophageal cyst. Given the oncologic background and to exclude metastatic disease, endoscopic ultrasound-guided fine needle aspiration was performed, and a mucinous fluid was aspirated. The cytologic examination supported the ultrasonographic diagnostic hypothesis. This case highlights the role of endoscopic ultrasound in the differential diagnosis of mediastinal masses, particularly in oncologic patients, in order to rule out more ominous lesions.Sociedade Portuguesa de Gastrenterologia2017-08-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000400007GE-Portuguese Journal of Gastroenterology v.24 n.4 2017reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000400007Martins,CláudioSousa,PaulaAraújo,TarcísioCastro-Poças,FernandoPedroto,Isabelinfo:eu-repo/semantics/openAccess2024-02-06T17:33:46Zoai:scielo:S2341-45452017000400007Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:36:01.004594Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge
title Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge
spellingShingle Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge
Martins,Cláudio
Endosonography
Esophageal cyst, diagnosis
Colorectal neoplasms
Lymphatic metastasis
Mediastinum
title_short Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge
title_full Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge
title_fullStr Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge
title_full_unstemmed Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge
title_sort Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge
author Martins,Cláudio
author_facet Martins,Cláudio
Sousa,Paula
Araújo,Tarcísio
Castro-Poças,Fernando
Pedroto,Isabel
author_role author
author2 Sousa,Paula
Araújo,Tarcísio
Castro-Poças,Fernando
Pedroto,Isabel
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Martins,Cláudio
Sousa,Paula
Araújo,Tarcísio
Castro-Poças,Fernando
Pedroto,Isabel
dc.subject.por.fl_str_mv Endosonography
Esophageal cyst, diagnosis
Colorectal neoplasms
Lymphatic metastasis
Mediastinum
topic Endosonography
Esophageal cyst, diagnosis
Colorectal neoplasms
Lymphatic metastasis
Mediastinum
description The differential diagnosis of mediastinal masses involves many benign and malignant conditions, such as lymphadenopathies and cystic lesions. Metastatic mediastinal adenopathies are usually due to lung, esophagus, and stomach cancer and, rarely, due to colorectal cancer. Gastrointestinal duplication cysts are uncommon inherited lesions usually diagnosed during childhood and may involve the esophagus in 20% of cases. In adults, they are usually asymptomatic and diagnosed incidentally. We report the case of a 54-year-old male who recently underwent sigmoidectomy due to an obstructive colon adenocarcinoma. Staging computed tomography scan showed a hypodense lesion in the posterior mediastinum suggestive of metastatic adenopathy. Endoscopic ultrasound revealed a homogeneous and hypoechogenic lesion with intramural location in the upper esophagus, suggestive of a duplication esophageal cyst. Given the oncologic background and to exclude metastatic disease, endoscopic ultrasound-guided fine needle aspiration was performed, and a mucinous fluid was aspirated. The cytologic examination supported the ultrasonographic diagnostic hypothesis. This case highlights the role of endoscopic ultrasound in the differential diagnosis of mediastinal masses, particularly in oncologic patients, in order to rule out more ominous lesions.
publishDate 2017
dc.date.none.fl_str_mv 2017-08-01
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dc.language.iso.fl_str_mv eng
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dc.publisher.none.fl_str_mv Sociedade Portuguesa de Gastrenterologia
publisher.none.fl_str_mv Sociedade Portuguesa de Gastrenterologia
dc.source.none.fl_str_mv GE-Portuguese Journal of Gastroenterology v.24 n.4 2017
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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