Abstract
Calcifying fibrous tumor (CFT) is a benign tumor entity which can present in a variety
of different sites. Till date, eight cases with a mediastinal manifestation have been
published in literature. Surgical removal is the treatment of choice for this often
incidentally detected tumor. Surgery of thoracic CFT may be challenging due to its
localization within the mediastinum. A 10-year old boy with a right-sided thoracic
pectus carinatum-like deformity was referred for further evaluation, incidentally,
revealing a mediastinal mass in computed tomography (CT). Laboratory results were
all within normal range. Magnetic resonance imaging (MRI) showed a large tumor in
the upper anterior mediastinum suggesting expansive but not infiltrative character.
The tumor was displacing surrounding structures like the heart and the diaphragm.
Lower venous stasis with dilation of the inferior cava vein could be demonstrated.
The tumor was considered to be of benign dignity and surgical removal was indicated.
Complete tumor resection could be achieved through a sternotomy approach, along with
thymectomy. A partial resection of both the pericardium and diaphragm was required
due to adhesion with soft tissue at those sites. The specimen's size was 320 mm × 145 mm × 100 mm,
histologically confirmed as CFT. The patient showed no residual tumor at 3- and 9-month
follow-up. This case is a report on a large mediastinal CFT which underwent successful
complete surgical removal. Following tumor resection, prognosis is considered to be
good; however, key issue is complete resection to avoid local tumor recurrence.
Keywords
calcifying fibrous tumor - pericardial resection - pediatric tumor surgery
