A 59-YEAR-OLD woman was referred to the surgical service for evaluation of a thoracic mass. She complained of difficulty breathing and a progressive, nonproductive cough. A chest radiograph and computed tomographic scan showed a large right-sided chest mass compressing the right upper lobe of the lung (Figure 1), with tracheal and aortic arch deviation (Figure 2). Magnetic resonance imaging showed the mass to be homogeneous.
After a biopsy of the mass guided by means of computed tomography, she underwent an elective thoracotomy. The mass was confined to the right side of the upper chest cavity, with significant compression of the right lung. It measured 12 × 16 cm and weighed 920 g.
B. Malignant schwannoma
C. Benign neurilemoma
D. Pulmonary sequestration
Corresponding author: Gregory P. Victorino, MD, Department of Surgery, University of California–San Francisco, East Bay, 1411 E 31st St, Oakland, CA 94602.
Newton CR, Victorino GP. Image of the Month—Quiz Case. Arch Surg. 2003;138(3):341. doi:10.1001/archsurg.138.3.341