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Case Report
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| Retrocardiac mass in a patient with cirrhosis: A case report | ||||||
| Mehdi Saeidpour1, Karin Steinke2 | ||||||
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1ICU Registrar, ICU Department, Hervey Bay Hospital, Hervey Bay, Queensland, Australia.
2Associate Professor of Radiology, Department of Medical Imaging (DMI), Royal Brisbane and Women’s Hospital (RBWH), Brisbane, Queensland, Australia. | ||||||
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| How to cite this article |
| Saeidpour M, Steinke K. Retrocardiac mass in a patient with cirrhosis: A case report. International Journal of Case Reports and Images 2014;5(1):50–53. |
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Abstract
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Introduction:
The most common cause of a supradiaphragmatic posterior mediastinal mass is a hiatus hernia. However, an unexplained round or lobulated retrocardiac shadow without air or air-fluid level in patients with marked portal hypertension should raise the suspicion of dilated venous collaterals.
Case Report: This is a case of a 58-year-old Asian male with a history of chronic liver disease secondary to alcohol abuse and hepatitis B and banding of esophageal varices due to bleeding presenting to the hospital after a low-velocity motor vehicle accident. Plain X-ray of chest showed a double density structure through the left cardiac shadow. Further investigation revealed paraesophageal varices simulating a retrocardiac mass on a contrast enhanced helical computed tomography scan of the abdomen. Conclusion: Differential diagnoses of mediastinal, retroperitoneal, and mesenteric masses in patients with cirrhosis most commonly include varices rather than a neoplasm or adenopathy. Portosystemic collateral veins most likely need many years to reach such a size that they can be visible on a chest X-ray. Giant esophageal varices may present as a posterior mediastinal mass on a chest X-ray in as many as 5% of cirrhotic patients. Diagnosis may be confirmed by Doppler ultrasonography, computed tomography scan, or magnetic resonance imaging scan. Correct interpretation of a pseudotumor caused by venous collaterals may avoid potentially hazardous invasive diagnostic procedures. | |
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Keywords:
Retrocardiac mass, Portal hypertension, Chronic liver disease, Esophageal varices
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Author Contributions
Mehdi Saeidpour – Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published Karin Steinke – Conception and design, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Mehdi Saeidpour et al. 2014; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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About The Authors
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