Dumbbell-shaped mediastinal neurogenic tumor forming a string-of-beads structure

摘要

A 38-year-old man had an abnormal shadow in the left upper lung field of a chest radiograph taken by his family physician. A chest computed tomographic scan showed a homogeneous tumor 10 cm in diameter with a string of 4 beads along the fourth intercostal space, originating from the posterior mediastinum and projecting from the spinal canal between the fourth and fifth thoracic vertebrae (Th4 and Th5). Magnetic resonance imaging revealed a thoracic dumbbell-shaped tumor producing spinal cord compression in the extradural space (Figure 1). Serum chemistry and blood counts were within normal limits and the patient had no paralytic symptoms or cafe-au-lait spots.