CTICasesCavitary Pulmonary Metastases from Thymic Carcinoma
Imaging findings
Initial chest CT shows a large, aggressive, infiltrating prevascular mediastinal mass causing superior vena cava syndrome. Follow-up CT scans obtained three months after radiation and chemotherapy show a significant reduction in the size of the mediastinal mass with radiation-induced parenchymal changes. However, multiple new, thin-walled, cavitary pulmonary nodules resembling "Cheerio" lesions have rapidly developed throughout both lungs.
Key takeaways
Cavitary pulmonary metastases, often referred to as "Cheerio" lesions, are typically associated with adenocarcinomas from the colon or lung but can also occur with aggressive anterior mediastinal malignancies like thymic carcinoma. These lesions represent rapidly progressive metastatic disease that may develop over a short interval even while the primary tumor shows a response to local therapy such as radiation.
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