case_images: PMC11764210_01
case_images: Conventional chest radiography of the patient from the presentations in 2008 (a), 2018 (b), and 2023 (c) showing significant growth over time of the dense opacity caused by the tumor, with massive compression of both lungs and mediastinal shift towards right hemithorax.
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case_images: Figure 2a-c and Figure 3a-c illustrate the conventional radiological and CT appearances of tumor growth over time, from 2008 to 2018 and 2023.
case_images: CT scan from the same presentations in 2008 (a), 2018 (b), and 2023 (c), revealing the large mediastinal mass consisting of inhomogeneous tissue with fatty densities, fibrous trabeculae, and intratumorally calcification.
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case_images: Figure 2a-c and Figure 3a-c illustrate the conventional radiological and CT appearances of tumor growth over time, from 2008 to 2018 and 2023.
case_images: Clamshell incision (a) and first step of the tumor resection by mobilizing the right-sided component (b).
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case_images: A clamshell incision was made in the fourth intercostal space to provide optimal exposure and facilitate the complete removal of the tumor (Figure 4a). The resection began with the right-sided component of the tumor (Figure 4b).
case_images: End stage of the tumor resection in the left hemithorax (a), chest cavity after tumor removal (b), and operative specimen (c).
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case_images: The tumor, measuring 50 x 30 x 15 cm and 6.84 kg in weight (Figure 5c), was found to be supplied predominantly by the left internal mammary artery. Despite the normalization of the heart position after resection, the compressed left lung failed to fully expand and occupy the entire left pleural cavity (Figure 5a-c).
case_images: Conventional chest radiography on postoperative day 4 with bilateral pleural drainage, and small left basal pneumothorax still present, as the left lung initially could not re-expand fully (a), and at discharge with closed left pleural space by smaller left lung and elevated left hemidiaphragm (b).
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case_images: The patient was discharged on postoperative day 18 in a good condition, and had fully recovered one month later without further complications (Figure 6a,b).