PMC4112985_01
PMC4112985_02
PMC4112985_03
CT scan of the chest. Sagittal CT scan image of the chest reveals a large mediastinal mass measuring 5.2 x 4.7 cm. There is no hilar or mediastinal lymphadenopathy.
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F1
Follow-up contrast-enhanced chest computed tomography (CT) revealed an anterior mediastinal mass measuring 5.2 x 4.7 cm in the sagittal section (Figure  1).
Body PET scan pre-surgery. PET scan of the chest and body reveals an anterior mediastinal mass measuring 5.0 x 5.1 cm with an SUV of 15. No additional suspicious masses or adenopathy are appreciated. There is an area of increased metabolic activity in the inferior aspect of the right hepatic lobe that is related to bowel activity.
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F2
A whole-body 18F-FDG-PET/CT scan demonstrated the anterior mediastinal mass, measuring 5.0 x 5.1 cm with an SUVmax of 15 (Figure  2).
Resected mediastinal mass surgical pathology. Hemotoxylin & Eosin stained section of resected mediastinal mass reveals scattered small Homer-Wright rosettes (arrows): small dark neuroblastoma cells in circular groups around pale fibrillary neuropil (200x magnification).
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F3
The tumor cells had a neuroendocrine appearance with abundant neutropil, formed rosettes, and a low mitotic index (<2% of cells) (Figure  3).
Body PET scan post-surgery. PET scan of the chest and body performed 7 months after surgical resection reveals no foci of abnormal FDG avid activity within the chest, no pulmonary nodules, and normal cardiomediastinal silhouette appearance.
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F4
Repeat PET scan 7 months after treatment indicated no mediastinal mass or residual disease (Figure  4).