CTICasesMetastatic Squamous Cell Carcinoma of the Skin Obscuring Anterior Mediastinum
Imaging findings
Initial chest x-ray frontal view appeared normal. The lateral view, however, showed filling in of the retrosternal clear space. Re-evaluation of the frontal view revealed massive asymmetry between the soft tissues of the left and right chest and filling in of the axilla. Subsequent PET-CT confirmed metastatic soft tissue and nodal tissue projecting over the anterior mediastinum.
Key takeaways
Always review the lateral chest x-ray, especially when the frontal view appears normal, as it can reveal abnormalities in the retrosternal clear space. Soft tissue metastases in the axilla and chest wall can project over the anterior mediastinum, mimicking an intrathoracic mass and filling the retrosternal clear space.
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