CTICasesEsophageal Carcinoma with Paratracheal Nodal Metastases
Imaging findings
Chest radiograph shows a right paratracheal abnormality with the trachea appearing mildly deviated; on the lateral view, unlike simple tortuous vessels, there is obliteration of the retrotracheal space (Raider's triangle) with anterior bowing of the trachea. Follow-up CT after the patient presented with chest pain and dysphagia confirms extensive right paratracheal soft tissue and a primary mass.
Key takeaways
The mass was a primary esophageal tumor arising from the proximal third of the esophagus, likely squamous cell carcinoma, with paratracheal metastatic lymphadenopathy accounting for the imaging findings. The case illustrates how obliteration of the retrotracheal space on the lateral radiograph, with anterior tracheal bowing, is a subtle but reliable clue to a significant posterior mediastinal mass that can otherwise be overlooked on the frontal view.
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