Decoding complex mediastinal masses in children: insights from a clinical case

Abstract

Introduction: In the pediatric population, any mediastinal mass represents a diagnostic challenge considering that most of these lesions have been associated with neoplasms. Advanced imaging modalities such as computed tomography (CT) have proven essential for the identification and characterization of mediastinal lesions. Objective: To explore the general nature of nerve cell tumors with a radiological approach. Clinical case: Three-year-old girl with respiratory symptoms with a mass in the mesogastrium of approximately 3 cm. Abdominal ultrasound reports a complex mass. Chest X-ray evidenced radiopacity in the left hemithorax. Plain contrast-enhanced CT of the chest and upper abdomen shows a solid, contrast-enhancing mass with a volume of approximately 387 cc. Discussion: In the posterior mediastinum, nerve cell tumors are generally grouped into three categories: peripheral nerve, paraganglia, or autonomic ganglion cells, whether sympathetic or parasympathetic, with an incidence of 70%, 25%, and 1-2%. respectively. Conclusion: Posterior mediastinal lesions in pediatric patients should focus on the study of lymph node tumors due to their high incidence, in addition, they should be evaluated using objective radiological characteristics to avoid complications and consequently take prompt therapeutic action.