12 April 2020 : Case report
Case Report of a Mediastinal Vascular Malformation Mimicking Esophageal Varices on Endoscopy, with Emphasis on Radiological Findings
Mistake in diagnosis, Rare diseaseMark Wang1ABCDEF*, Wei Keat Wan2CDE, Joe Francis1ABCDE
Am J Case Rep 2020; 21:e922163
BACKGROUND: Mediastinal vascular malformations are rare, and most patients are asymptomatic or present with unrelated symptoms. Imaging can be challenging to interpret, but plays an important role in diagnosis and prognostication.
CASE REPORT: We present the case of a 48-year-old man with history of intravenous drug abuse and incompletely treated pulmonary tuberculosis. A computed tomography (CT) scan done for respiratory symptoms showed an extensive soft-tissue mass in the mediastinum and upper abdomen, initially thought to represent tuberculous adenitis with possible esophageal involvement, which appeared variceal in nature on endoscopy. Further investigation with open mediastinal biopsy and magnetic resonance imaging (MRI) eventually led to the diagnosis of a low-flow venous mediastinal vascular malformation. The patient responded well to conservative management, with the malformation remaining stable on follow-up CT up to a decade later.
CONCLUSIONS: Radiologists should be aware of the rare but important differential diagnosis of a vascular malformation, particularly when an extensive infiltrative calcified mediastinal soft-tissue mass is encountered. Multi-modality imaging, particularly MRI, which can demonstrate typical features, is crucial for diagnosis and prognostication, thereby avoiding unnecessary invasive procedures and treatment.
Keywords: Esophageal and Gastric Varices, Mediastinum, Radiology, Tuberculosis, vascular malformations, Diagnosis, Differential, Endoscopy, Middle Aged
27 Jan 2023 : Case reportA 37-Year-Old Man with Familial Hereditary Hemorrhagic Telangiectasia and Pulmonary Arteriovenous Malformat...
Am J Case Rep In Press; DOI: 10.12659/AJCR.938548
26 Jan 2023 : Case reportA 39-Year-Old Woman with Endometriosis Who Developed a Subcapsular Liver Hematoma Following Laparotomic Sur...
Am J Case Rep In Press; DOI: 10.12659/AJCR.938169
26 Jan 2023 : Case reportOptic Neuritis as a Consequence of Long-Term Medical Treatment Using Anastrozole: A Case Report
Am J Case Rep In Press; DOI: 10.12659/AJCR.939026
Most Viewed Current Articles
13 Jul 2022 : Case reportWhistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound
Am J Case Rep 2022; 23:e936441
06 Dec 2021 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406
23 Feb 2022 : Case reportPenile Necrosis Associated with Local Intravenous Injection of Cocaine
Am J Case Rep 2022; 23:e935250