Calcified mediastinal mass found during aortic valve replacement

Calcified mediastinal mass found during aortic valve replacement A 58‐year‐old male with a history of polyarthritis was admitted with aortic valve endocarditis with blood cultures positive for Staphylococcus aureus. A preoperative computed tomography (CT) scan showed a calcified mediastinal mass (Figure A). At the time of surgery, a 3 × 3‐cm calcified mass was found in the remnant of thymic tissue and was completely excised. The aortic valve was excised and replaced with a #23 Carbomedics mechanical valve (Sorin Group, Inc., Saluggia, Italy). The patient tolerated the procedure well and had an uncomplicated post‐operative course. On gross inspection, the mass consisted of a calcified rim of tissue with a cystic cavity containing mucinous material. The histology showed atypical cells with pleomorphic nuclei forming glandular structures. CK‐20, CDX2, and CA 19.9 positive expression suggested a tumor of intestinal lineage (Figure ). This was consistent with a mucinous type adenocarcinoma. The tumor was positive for CD5 expression which classified it as a thymic mucinous adenocarcinoma. The patient received four courses of radiotherapy and a follow‐up CT scan at 1 year showed no tumor recurrence (Figure B).Tomography findings: (A) Preoperative computed tomography showed the calcified tumor lesion (red arrow). (B), Computed tomography after 1 year of the surgery and radiotherapyPathological analysis: (A) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Cardiac Surgery Wiley

Calcified mediastinal mass found during aortic valve replacement

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
0886-0440
eISSN
1540-8191
D.O.I.
10.1111/jocs.13522
Publisher site
See Article on Publisher Site

Abstract

A 58‐year‐old male with a history of polyarthritis was admitted with aortic valve endocarditis with blood cultures positive for Staphylococcus aureus. A preoperative computed tomography (CT) scan showed a calcified mediastinal mass (Figure A). At the time of surgery, a 3 × 3‐cm calcified mass was found in the remnant of thymic tissue and was completely excised. The aortic valve was excised and replaced with a #23 Carbomedics mechanical valve (Sorin Group, Inc., Saluggia, Italy). The patient tolerated the procedure well and had an uncomplicated post‐operative course. On gross inspection, the mass consisted of a calcified rim of tissue with a cystic cavity containing mucinous material. The histology showed atypical cells with pleomorphic nuclei forming glandular structures. CK‐20, CDX2, and CA 19.9 positive expression suggested a tumor of intestinal lineage (Figure ). This was consistent with a mucinous type adenocarcinoma. The tumor was positive for CD5 expression which classified it as a thymic mucinous adenocarcinoma. The patient received four courses of radiotherapy and a follow‐up CT scan at 1 year showed no tumor recurrence (Figure B).Tomography findings: (A) Preoperative computed tomography showed the calcified tumor lesion (red arrow). (B), Computed tomography after 1 year of the surgery and radiotherapyPathological analysis: (A)

Journal

Journal of Cardiac SurgeryWiley

Published: Jan 1, 2018

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