Seeking Insights on Anterior Mediastinal Mass
Greetings, everyone! This is my inaugural post on Reddit, so please bear with me as I navigate through my thoughts. I’m a 34-year-old female and recently discovered an incidental finding of a mass measuring 3.9 x 1.5 x 1.9 cm during a CT scan that was performed due to tapering in my jugular vein. For the past year, I've experienced symptoms such as shortness of breath and localized chest discomfort. Initially, my medical team and I attributed these issues to ankylosing spondylitis (AS), which I have, assuming it was affecting my ribs and sternum. However, this suspicion was never substantiated by imaging; it was primarily a theory on my part. I have also been grappling with severe fatigue, intermittent fevers, and night sweats, which I believed were linked to my existing health complications. I now question if this mass might have been the underlying cause all along. Here are some pertinent aspects of my medical history: - I have a long-standing issue with reactive lymph nodes, with two currently being monitored via ultrasound every few months. They appear reactive according to the ultrasound results. - There is a familial tendency towards hereditary hypertension that has been challenging to manage. Presently, I'm on a combination of amlodipine and lisinopril and have previously taken carvedilol. - I'm on atorvastatin to address hyperlipidemia. I maintain an active lifestyle, have a healthy weight, and follow a clean diet, adhering to a vegetarian lifestyle for nearly 28 years. - I also have ankylosing spondylitis, for which I’m undergoing treatment with biologics. - My family background includes extensive occurrences of cancer and heart-related conditions. My father passed away from a heart attack at age 40, and both his brothers and father suffered heart attacks before turning 50, though they survived. My mother’s side has a significant cancer history, with three of her sisters surviving different types. Switching back to the mass, it presents with low density on imaging. It was initially noted on a 2022 CT scan when I was evaluated for chronic bronchitis and pneumonia, but regrettably, this finding was not communicated to me. The ENT who ordered the scans relayed the information to an interventional radiologist. After reviewing my imaging history, the radiologist informed me of the previous findings. He mentioned that the mass hadn't increased in size, which is reassuring in regard to malignancy risk, but suggested a follow-up MRI with contrast, as my arm positioning differed between the two scans. I just completed that MRI today. Upon reviewing my medical chart ahead of a forthcoming appointment, I came across an addendum pertaining to this year’s CT that includes: - "A lobulated low-density lesion in the anterior mediastinum measuring 3.9 x 1.0 x 1.9 cm has been identified, consistent with a similar lesion from 2022, which measured 3.3 x 2.0 x 1.5 cm. The size has not shown significant change, though it’s crucial to note the arm positioning discrepancy between the studies. The stability observed tends to suggest a benign nature." To further clarify, the original 2025 CT mentioned a low-density lobular lesion in the anterior mediastinum measuring 3.5 x 1.0 x 1.9 cm. It seems there are variances in size reported for the mass over time, and I am concerned because it appears to have changed not just in size but potentially in shape, especially given my symptoms and its location. Additionally, recent lab tests indicated I have low potassium and iron levels, alongside mildly elevated neutrophils. I insisted on being referred to a thoracic surgeon, and my doctor facilitated that without hesitation. I'll be seeing him soon. My primary questions are: - In light of my symptoms, the growth of the mass, and my family history, would it be wise to consider a biopsy? - Based on its size, location, and my symptoms, would surgical removal be advisable? If so, what implications should I anticipate? - Can anyone explain the differences in reported size across the radiology reports? Might the MRI reveal a different measurement compared to the CT? - Finally, how serious is this finding? I apologize for the lengthy post; I feel quite overwhelmed and am searching for some clarity on this matter. I truly appreciate any thoughts or guidance you can provide. I'm also happy to answer any additional questions you might have.
Answers (1)
8/20/2025, 3:01:45 AM
OpenHealth AI
Thank you for sharing your situation; it’s understandable to feel overwhelmed by these findings, especially with your existing health conditions and family history. Let’s break this down into the main points and provide some insights and next steps for you.
Main Points:
- You have an anterior mediastinal mass that has been stable in size over time, which may suggest a benign nature, but it's important to investigate it further due to your symptoms.
- Considering your family history of malignancies and your ongoing symptoms, further evaluation (including possible biopsy) is reasonable.
- Differences in size measurements between CT and MRI can occur due to various factors, including positioning and imaging technique.
Explanation:
-
Mass Characteristics: The fact that the mass has remained stable in size is reassuring; however, your symptoms (shortness of breath, chest discomfort, fatigue, intermittent fevers, and night sweats) warrant careful evaluation. A mass in the anterior mediastinum can be related to various conditions, including benign processes (like thymoma or teratoma) or, less commonly, malignancies.
-
Family History and Symptoms: Given your family history of cancer and heart disease, along with your concerning symptoms, it is sensible to consider a biopsy. A biopsy can provide a definitive diagnosis and guide further management.
-
Variability in Measurements: Variations in reported sizes across imaging studies may result from different positioning, breathing techniques during the scan, or differences in image interpretation by radiologists. It is common for small discrepancies to occur, and the MRI may help provide additional clarity concerning the mass’s characteristics.
Next Steps:
-
Discuss Biopsy with Your Thoracic Surgeon: Bring up the possibility of a biopsy during your appointment. Explain your symptoms and family history. A biopsy can yield valuable diagnostic information to clarify the nature of the mass.
-
Follow-Up on MRI Results: While you wait for the thoracic surgeon appointment, ensure you understand the findings of the recent MRI. Ask for clarification on how this imaging might change or confirm the understanding of the mass's characteristics.
-
Prepare for Discussion on Surgical Options: If a biopsy indicates that surgical removal is an option, your surgeon will discuss the potential benefits and risks with you. Surgical interventions can vary, but understanding what to expect will help you feel more prepared.
-
Monitor Symptoms: Keep a log of your symptoms, noting when they occur and their severity. This information can be invaluable in discussions with your healthcare team and during your surgical consultation.
Support:
It’s natural to feel anxious in situations like this. Surround yourself with supportive friends or family who can help you through this process. Remember, gathering thorough information and asking questions will help you feel more in control as you navigate your care.
Feel free to reach out if you have more questions or need emotional support during this time. You are not alone in this.
Related Questions
Seeking Insights: My Journey with Undiagnosed Neurological Symptoms
Hello everyone, I'm a 34-year-old female grappling with neurological symptoms that first appeared in October, and I’m eager to hear from anyone who might have faced similar challenges. My journey began with unexpected migraines, blurred vision, and an ongoing sensation of being off-balance or intoxicated. Gradually, I began experiencing mainly sensory-related symptoms, such as tingling and burning sensations, feelings of extreme heat and cold, sharp pains radiating in my arms and back, as well as discomfort in my hands and toes, alongside intermittent numbness. I also endure varying degrees of weakness and heaviness in my right side, specifically my arm and leg, although I haven’t suffered complete functional loss. The nature of my symptoms is erratic; they fluctuate rather than consistently deteriorate. An MRI revealed mild, scattered lesions in the white matter, which were deemed nonspecific. Further tests from a lumbar puncture returned normal results, showing no markers of inflammation, and the oligoclonal bands were not present. A thorough range of lab tests yielded no significant findings. After evaluating my case, the neurology team suggested a possible diagnosis of MS and administered a three-day course of intravenous steroids. While I noticed a slight improvement in some sensory pain, my symptoms persist and continue to vary day by day. I still experience headaches and pressure in my head along with episodes of blurred vision, but there have been no new deficits since treatment. I am reaching out to connect with others who have had similar experiences. I would like to learn about the insights or diagnoses you encountered and what treatments proved beneficial (such as those related to migraine disorders, dysautonomia, or sensory neuropathy, for example). If you have navigated a similar path, I would greatly appreciate your sharing your story. Thank you!
Should I Seek Medical Attention for Left Ear Pulsatile Tinnitus?
A 31-year-old woman reports an ongoing issue with pulsatile tinnitus, which she is currently experiencing solely in her left ear. Although she's noticed this condition intermittently before, she hadn’t paid it much mind due to the absence of pain. Recently, however, her curiosity piqued her interest in researching the condition, where she stumbled upon information suggesting it could be serious. Usually, she avoids searching online for health worries, but now she is contemplating whether a visit to the doctor might be warranted. Can anyone advise on the need for a medical evaluation in this case?
Concerns About Angular Cheilitis
I’m a 23-year-old woman with no history of smoking, and I’m seeking assistance regarding a health issue. Back in January, I experienced angular cheilitis three times, each episode involving a minor crack at the corner of my mouth that healed within a few days. Following the last occurrence, I became quite anxious due to saliva accumulation in that area. I found myself frequently brushing my finger along that spot. After a few days, I observed a small area forming that appeared white and had a rough texture. Eventually, I realized it was not just a coincidence, and I started taking action, but only after it became noticeably larger. To address it, I cleaned the area with a mix of alcohol and apple cider vinegar. I’m uncertain about what this issue could be, but I’ve recently begun using over-the-counter Clotrimazole cream while also keeping the area moisturized with either lanolin or petroleum jelly. Unfortunately, I haven’t noticed any improvement, and I’m concerned as it seems to be expanding. The patch continues to be rough and excessively dry. Although I can open my mouth wide without any cracks forming, I do feel tension in the skin, similar to having a bandage over that location. At times, I experience a burning sensation after thorough washing, and I’ve noticed tiny red spots appearing on the outer edges of the patch sporadically.
Mass on the Glottis
Patient Details: 63-year-old male, height 165 cm, weight 66 kg, Asian descent. Lifestyle Factors: No history of smoking or alcohol consumption. Medical History: Diagnosed with asthma and angina. Current Medications: Uses a Symbicort inhaler and takes Concor tablets. Main Concern: A mass was detected during a gastroendoscopy carried out a year ago. There is no report of pain, but the patient experiences mild hoarseness. What might be the diagnosis?
Experiencing Heart Palpitations Following Chest Impact
I'm a 17-year-old female who has struggled with tachycardia for several years, having been diagnosed with postural tachycardia syndrome (POTS) about five years ago, although I haven't pursued further testing because I haven't completely lost consciousness. Recently, over the past month or two, I've started to experience sensations of my heart skipping beats, accompanied by difficulty in breathing during these episodes. These occurrences have become significantly more frequent, even when I'm at rest. Five years ago, I underwent a Holter monitor test, which indicated primarily tachycardia with occasional premature ventricular contractions (PVCs), but nothing alarming was found. In early December, I was struck hard in the chest by an elbow while in a mosh pit, which resulted in some pain when taking deep breaths for a few days. My sternum became bruised and slightly swollen, and it remained tender to touch for about two weeks, but this discomfort was manageable. I still feel some soreness when stretching, although it’s not severe. Additionally, I have diagnoses of Crohn’s disease and hypermobile Ehlers-Danlos syndrome (HEDS), and I am currently on immunosuppressants. Given these circumstances, would it be advisable for me to seek medical evaluation, or could these symptoms be considered typical?