case_images: PMC7451151_01
case_images: Chest X-ray showing large oval mass like density in posterior segment right upper lobe measuring up to 10.4 cm superior-inferior by 7.8 cm anterior-posterior (a) and 8.9 cm transverse (b). Other pathological findings are not seen.
case_images: SNI-11-234-g001.jpg
case_images: PMC7451151_01_SNI-11-234-g001.jpg
case_images: F1
case_images: However, the ensuing chest X-ray (CXR) showed a large oval mass-like density in the posterior segment of the right upper lobe [Figure 1].
case_images: Computed tomography chest pulmonary angiogram showing a low-density mass in the posterior right hemithorax with no significant eccentric or solid/nodular enhancement. The findings suggest a neoplasm arising from the right T5-6 neural foramen.
case_images: SNI-11-234-g002.jpg
case_images: PMC7451151_01_SNI-11-234-g002.jpg
case_images: F2
case_images: A 16 mm thick right pleural effusion was also described [Figure 2].
case_images: (a and b) Preoperative magnetic resonance imaging gadolinium of the chest demonstrating a large, mildly heterogenic hyperenhancing mass within the posterior right upper/mid- hemithorax (7.2 x 9.2 x 8.5 cm) extending to the level of the right C5-6 neural foramen. T1 isointensity and mild T2 hyperintensity relative to muscle are reported. Small right pleural effusion, up to 13 mm is noted. No other pathological findings are observed.
case_images: SNI-11-234-g003.jpg
case_images: PMC7451151_01_SNI-11-234-g003.jpg
case_images: F3
case_images: A focal contrast-enhancing protrusion of the right posterior medial aspect of the mass extending into the right T5-6 neural foramen suggested that the mass emanated from the neural foramen [Figure 3].
case_images: (a) Chest X-ray 24 h postsurgery; Right-sided chest tube and mediastinal drain are noted. No evidence of residual pneumothorax. A right internal jugular catheter is noted with the distal tip in the region of the right atrium. Interval resection of the previously noted right mediastinal mass. No evidence of pleural effusion. Osseous structures remain unremarkable. (b) and (c): CT chest a month postsurgery: normal findings, no evidence of recurrence.
case_images: SNI-11-234-g004.jpg
case_images: PMC7451151_01_SNI-11-234-g004.jpg
case_images: F4
case_images: The patient was transferred to the intensive care unit postoperatively; her evolution at the hospital proved uncomplicated with follow-up serial CXRs remaining unremarkable [Figure 4a]. A CT scan of the chest 1 month postsurgery showed normal findings [Figure 4b and c].