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Martins C, Sousa P, Araújo T, et al. Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge. GE Port J Gastroenterol. 2016;24(4):193-197doi: 10.1159/000452696.
Martins, C., Sousa, P., Araújo, T., Castro-Poças, F., & Pedroto, I. (2017). Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge. GE Portuguese journal of gastroenterology, 24(4), 193-197. https://doi.org/10.1159/000452696
Martins, Cláudio, et al. "Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge." GE Portuguese journal of gastroenterology vol. 24,4 (2017): 193-197. doi: https://doi.org/10.1159/000452696
Martins C, Sousa P, Araújo T, Castro-Poças F, Pedroto I. Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge. GE Port J Gastroenterol. 2017 Jul;24(4):193-197. doi: 10.1159/000452696. Epub 2016 Nov 22. PMID: 29255750; PMCID: PMC5729942.
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GE Port J Gastroenterol. 2017 Jul;24(4):193-197. doi: 10.1159/000452696. Epub 2016 Nov 22.

Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge.

GE Portuguese journal of gastroenterology

Cláudio Martins, Paula Sousa, Tarcísio Araújo, Fernando Castro-Poças, Isabel Pedroto

Affiliations

  1. Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Setúbal, Portugal.
  2. Gastroenterology Department, Hospital de São Teotónio, Centro Hospitalar de Tondela/Viseu, Viseu, Portugal.
  3. Gastroenterology Department, Hospital Geral de Santo António, Centro Hospitalar do Porto, Porto, Portugal.
  4. Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.

PMID: 29255750 PMCID: PMC5729942 DOI: 10.1159/000452696

Abstract

The differential diagnosis of mediastinal masses involves many benign and malignant conditions, such as lymphadenopathies and cystic lesions. Metastatic mediastinal adenopathies are usually due to lung, esophagus, and stomach cancer and, rarely, due to colorectal cancer. Gastrointestinal duplication cysts are uncommon inherited lesions usually diagnosed during childhood and may involve the esophagus in 20% of cases. In adults, they are usually asymptomatic and diagnosed incidentally. We report the case of a 54-year-old male who recently underwent sigmoidectomy due to an obstructive colon adenocarcinoma. Staging computed tomography scan showed a hypodense lesion in the posterior mediastinum suggestive of metastatic adenopathy. Endoscopic ultrasound revealed a homogeneous and hypoechogenic lesion with intramural location in the upper esophagus, suggestive of a duplication esophageal cyst. Given the oncologic background and to exclude metastatic disease, endoscopic ultrasound-guided fine needle aspiration was performed, and a mucinous fluid was aspirated. The cytologic examination supported the ultrasonographic diagnostic hypothesis. This case highlights the role of endoscopic ultrasound in the differential diagnosis of mediastinal masses, particularly in oncologic patients, in order to rule out more ominous lesions.

Keywords: Colorectal neoplasms; Endosonography; Esophageal cyst, diagnosis; Lymphatic metastasis; Mediastinum

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