EURORAD ESR

Case 8555

Ewing's sarcoma presenting as a posterior mediastinal mass

Author(s)
Duarte R1, Miranda D2, Mato H3, Sanches C3, Noruegas MJ3, Coelho P3

1Centro Hospitalar de Gaia/ Espinho
2Unidade Local Saúde Matosinhos - Hospital Pedro Hispano
3Centro Hospitalar de Coimbra
 
Patient
female, 10 year(s)
 
 
  • Figure 1
    Chest radiograph
     

    (a) Posteroanterior and (b) lateral chest radiograph shows a large well-circumscribed mass in the posterior mediastinum (arrows).

     

    (a) Posteroanterior and (b) lateral chest radiograph shows a large well-circumscribed mass in the posterior mediastinum (arrows).

     
     
     
  • Figure 2
    Chest CT
     

    (a) Axial nonenhanced, (b) axial contrast-enhanced, (c) axial bone window and (d) sagital reformation bone window CT images shows a large heterogeneously enhancing mass (large arrows) in the posterior mediastinum,...

     

    (a) Axial nonenhanced, (b) axial contrast-enhanced, (c) axial bone window and (d) sagital reformation bone window CT images shows a large heterogeneously enhancing mass (large arrows) in the posterior mediastinum,...

     

    (a) Axial nonenhanced, (b) axial contrast-enhanced, (c) axial bone window and (d) sagital reformation bone window CT images shows a large heterogeneously enhancing mass (large arrows) in the posterior mediastinum,...

     

    (a) Axial nonenhanced, (b) axial contrast-enhanced, (c) axial bone window and (d) sagital reformation bone window CT images shows a large heterogeneously enhancing mass (large arrows) in the posterior mediastinum,...

     
     
     
  • Figure 3
    Thoracic spine MRI
     

    (a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to...

     

    (a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to...

     

    (a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to...

     

    (a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to...

     

    (a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to...

     
     
     
(a) Posteroanterior and (b) lateral chest radiograph shows a large well-circumscribed mass in the posterior mediastinum (arrows).
 
(a) Posteroanterior and (b) lateral chest radiograph shows a large well-circumscribed mass in the posterior mediastinum (arrows).
 
(a) Axial nonenhanced, (b) axial contrast-enhanced, (c) axial bone window and (d) sagital reformation bone window CT images shows a large heterogeneously enhancing mass (large arrows) in the posterior mediastinum, adjacent to the thoracic vertebral bodies, that compresses the heart and encases the descending aorta (open arrow). There is extension to the spinal canal (small arrows), as well as permeative destruction and osteoclerosis of the 6th thoracic vertebral body (circle).
 
(a) Axial nonenhanced, (b) axial contrast-enhanced, (c) axial bone window and (d) sagital reformation bone window CT images shows a large heterogeneously enhancing mass (large arrows) in the posterior mediastinum, adjacent to the thoracic vertebral bodies, that compresses the heart and encases the descending aorta (open arrow). There is extension to the spinal canal (small arrows), as well as permeative destruction and osteoclerosis of the 6th thoracic vertebral body (circle).
 
(a) Axial nonenhanced, (b) axial contrast-enhanced, (c) axial bone window and (d) sagital reformation bone window CT images shows a large heterogeneously enhancing mass (large arrows) in the posterior mediastinum, adjacent to the thoracic vertebral bodies, that compresses the heart and encases the descending aorta (open arrow). There is extension to the spinal canal (small arrows), as well as permeative destruction and osteoclerosis of the 6th thoracic vertebral body (circle).
 
(a) Axial nonenhanced, (b) axial contrast-enhanced, (c) axial bone window and (d) sagital reformation bone window CT images shows a large heterogeneously enhancing mass (large arrows) in the posterior mediastinum, adjacent to the thoracic vertebral bodies, that compresses the heart and encases the descending aorta (open arrow). There is extension to the spinal canal (small arrows), as well as permeative destruction and osteoclerosis of the 6th thoracic vertebral body (circle).
 
(a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to the thoracic vertebral bodies, which is isointense to muscle with T1 weighting and hyperintense to muscle with T2 weighting with focal areas of high signal intensity, consistent with necrosis and fluid and has heterogeneous enhancement. Axial images clearly show the encased descending aorta traversing the mass (open arrow). This mass involves the body of the 6th thoracic vertebra (star) and extends to the epidural space (small arrows in a and b) thought the neural foramina at the 6th to 7th thoracic vertebrae without widening it (small arrow in e).
 
(a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to the thoracic vertebral bodies, which is isointense to muscle with T1 weighting and hyperintense to muscle with T2 weighting with focal areas of high signal intensity, consistent with necrosis and fluid and has heterogeneous enhancement. Axial images clearly show the encased descending aorta traversing the mass (open arrow). This mass involves the body of the 6th thoracic vertebra (star) and extends to the epidural space (small arrows in a and b) thought the neural foramina at the 6th to 7th thoracic vertebrae without widening it (small arrow in e).
 
(a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to the thoracic vertebral bodies, which is isointense to muscle with T1 weighting and hyperintense to muscle with T2 weighting with focal areas of high signal intensity, consistent with necrosis and fluid and has heterogeneous enhancement. Axial images clearly show the encased descending aorta traversing the mass (open arrow). This mass involves the body of the 6th thoracic vertebra (star) and extends to the epidural space (small arrows in a and b) thought the neural foramina at the 6th to 7th thoracic vertebrae without widening it (small arrow in e).
 
(a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to the thoracic vertebral bodies, which is isointense to muscle with T1 weighting and hyperintense to muscle with T2 weighting with focal areas of high signal intensity, consistent with necrosis and fluid and has heterogeneous enhancement. Axial images clearly show the encased descending aorta traversing the mass (open arrow). This mass involves the body of the 6th thoracic vertebra (star) and extends to the epidural space (small arrows in a and b) thought the neural foramina at the 6th to 7th thoracic vertebrae without widening it (small arrow in e).
 
(a) Axial T1-weighted, (b) axial T2-weighted, (c) contrast-enhanced T1-weighted, (d) coronal T2-weighted and (e) sagital T2-weighted MR images show a large mass (large arrow) in the posterior mediastinum, adjacent to the thoracic vertebral bodies, which is isointense to muscle with T1 weighting and hyperintense to muscle with T2 weighting with focal areas of high signal intensity, consistent with necrosis and fluid and has heterogeneous enhancement. Axial images clearly show the encased descending aorta traversing the mass (open arrow). This mass involves the body of the 6th thoracic vertebra (star) and extends to the epidural space (small arrows in a and b) thought the neural foramina at the 6th to 7th thoracic vertebrae without widening it (small arrow in e).
 
 
 
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