CTICasesMetastatic Melanoma of the Anterior Mediastinum
Imaging findings
CT chest shows a lobulated, FDG-avid mass in the anterior mediastinum and adjacent lymph nodes. The patient underwent thymectomy and phrenic nerve sacrifice. Pathology confirmed metastatic melanoma from an unknown primary.
Key takeaways
Metastatic melanoma can present as a solitary or dominant mediastinal mass from an unknown primary, mimicking a primary thymic neoplasm. Surgical resection often requires resection of adjacent structures, including the phrenic nerve, leading to diaphragmatic paralysis.
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