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JAMA Surgery Clinical Challenge
April 2016

Anterior Mediastinal Mass

Author Affiliations
  • 1Department of Surgery, Downstate Medical Center, State University of New York, Brooklyn
JAMA Surg. 2016;151(4):385-386. doi:10.1001/jamasurg.2015.4432

An asymptomatic 47-year-old woman underwent a radiographic screening to rule out tuberculosis prior to volunteering at her local hospital. The incidental finding of a mediastinal mass prompted a referral to her primary care physician, who elicited from the patient some complaints of mild but worsening orthopnea that was exacerbated when she would lie down. She denied any recent weight loss, muscle weakness, or diplopia. Her surgical history was significant for having undergone a cesarean section. She denied any radiation exposure. A computed tomographic scan of the chest was obtained (Figure, A), and the patient was referred to surgery for evaluation.

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