PMC9923160_01
(A) chest mass, (B) ultrasound, echogenic mass in the anterior mediastinum. (C) CT, The mass is in close contact with the xiphoid process. (D) MRI, the mass is near the pericardium.
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F1
With these findings, an ultrasound was requested, discovering an echogenic mass measuring 2.3 x 1.8 cm without vascularization and cardiac involvement (Figures 1A,B). Magnetic resonance imaging also proved that the pericardium was not compromised (Figures 1C,D).
(A) Mass invading the costal cartilages and sternum. (B) Reconstruction with prosthetic material.
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F2
A bioabsorbable mesh was used to repair the diaphragmatic defect and rigid fixation was placed on the ribs with stainless steel wires to reconstruct the thoracic wall, since bioabsorbable prosthetic material was unavailable; drains were placed, and the procedure was completed without complications (Figures 2A,B).
Pathology HE 4X, fusiform cells without nuclear hyperchromatism, hypocellular, and hyalinized areas are seen. Immunohistochemistry positive for Beta-catenin (Inset 40x).
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F3
Desmin, and S100. Desmoid fibromatosis (DF) was the final diagnosis (Figure 3).