Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

12 April 2020 : Case report  Singapore

Case Report of a Mediastinal Vascular Malformation Mimicking Esophageal Varices on Endoscopy, with Emphasis on Radiological Findings

Mistake in diagnosis, Rare disease

Mark Wang1ABCDEF*, Wei Keat Wan2CDE, Joe Francis1ABCDE

DOI: 10.12659/AJCR.922163

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


In Press

27 Jan 2023 : Case report  Spain

A 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 report  Spain

A 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 report  USA

Optic 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  

26 Jan 2023 : Case report  USA

A Rare Case of Ruptured Appendicitis Secondary to Metastatic Ovarian Cancer

Am J Case Rep In Press; DOI: 10.12659/AJCR.938982  

Most Viewed Current Articles

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

17 Feb 2022 : Case report  Oman

Myocarditis, Pulmonary Hemorrhage, and Extensive Myositis with Rhabdomyolysis 12 Days After First Dose of P...

DOI :10.12659/AJCR.934399

Am J Case Rep 2022; 23:e934399

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923