IMAGES IN CARDIAC SURGERY
Calcified mediastinal mass found during aortic valve
Adrián Narvaez Muñoz
Souhayla Souaf Khalafi
Nuria Escudero Garcia
Department of Cardiovascular Surgery, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
Department of Pathology, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
Adrián Narvaez Muñoz, Rua da Choupana s/n Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, 15706, Spain.
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 1A). 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 2). 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 1B).
Adrián Narvaez Muñoz http://orcid.org/0000-0003-3631-0118
How to cite this article: Narvaez Muñoz A, Souaf Khalafi S,
Escudero Garcia N. Calcified mediastinal mass found during
aortic valve replacement. J Card Surg. 2018;33:93–94.
J Card Surg. 2018;33:93–94. wileyonlinelibrary.com/journal/jocs © 2018 Wiley Periodicals, Inc.