Mass under sternum?

Started by clubdeac
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clubdeac

clubdeac

Full Member
15+ Year Member
This patient is presenting with a 4 year h/o insidious in onset retrosternal noncardiac chest pain. Can anyone tell me what this is directly under this patient's sternum. Don't mind the air, he had just had a cholecystectomy. The air does however however help to demarcate the mass under the sternum which appears to be just outside the peritoneum. Looks the same on MRI and does not light up with contrast
Abdominal mass.jpg
 
clubdeac said:
This patient is presenting with a 4 year h/o insidious in onset retrosternal noncardiac chest pain. Can anyone tell me what this is directly under this patient's sternum. Don't mind the air, he had just had a cholecystectomy. The air does however however help to demarcate the mass under the sternum which appears to be just outside the peritoneum. Looks the same on MRI and does not light up with contrastView attachment 223172
Click to expand...
You need to include more images.

This axial slice is almost fully in the abdomen. At most, the inferior most point of the xiphoid process is visible. Deep to that it looks like fat density with random locules of air. On this single slice, I'd say it's just fat, but more images may make a mass more apparent.
 
maxxor said:
You need to include more images.

This axial slice is almost fully in the abdomen. At most, the inferior most point of the xiphoid process is visible. Deep to that it looks like fat density with random locules of air. On this single slice, I'd say it's just fat, but more images may make a mass more apparent.
Click to expand...

Could also be packing material from surgery.
 
Yes sorry I'd die load the entire study if I knew how. By the same, I meant it was just read as subcutaneous fat. However the patient is complaining of significant pain. Don't have much to offer other than biopsy
 
update: patient seen by thoracic surgery and is being taken in for open excision and biopsy
 
update. below is the path report and 2 week f/u surgeon's note:

"Bony, cartilaginous tissue and skeletal muscle, designated from xiphoid process, excision: Unremarkable bony and cartilaginous tissue with trilineage hematopoiesis"


Patient returns for post op visit s/p xiphoidectomy on 9/15. He did very well
postoperatively, discharging on same day. His pain is markedly improved. He does
still report some msk pain on right posterior thorax, but states this could be
related to posture and activity level being low. He is ready to increase his
activity. Hasn't needed narcotic pain meds. Working normally. Good bowel/bladder
function. No fever, chills, n/v/d/c, chest pain ,sob.
 
clubdeac said:
This patient is presenting with a 4 year h/o insidious in onset retrosternal noncardiac chest pain. Can anyone tell me what this is directly under this patient's sternum. Don't mind the air, he had just had a cholecystectomy. The air does however however help to demarcate the mass under the sternum which appears to be just outside the peritoneum. Looks the same on MRI and does not light up with contrastView attachment 223172
Click to expand...
I for one just like the starry-sky background. How can we get this as an option for our PACS?
 
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