fat containing mediastinal masses
- related: lung mass and cancer
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The differential diagnosis of a mediastinal lesion with fat attenuation in an adult, in addition to a liposarcoma, includes lipomas, teratomas, thymolipomas, and thymoliposarcomas.
Lipoblastomas can also be found in the mediastinum, although these benign tumors occur in infancy and early childhood and more commonly appear on the trunk, extremities, and head and neck.
Mediastinal lipomas are slow-growing benign tumors mostly found in the anterior mediastinum. Patients often do not have symptoms but can also develop symptoms owing to compression of surrounding structures.
Mediastinal teratomas are germ cell tumors that are typically benign and have a cystic appearance characterized by the inclusion of fluid; fat; and, in 20% to 40% of cases, calcification that can be formed teeth. They are also mostly found in the anterior mediastinal compartment.
A thymolipoma is a benign, slow-growing mediastinal tumor that contains both fat and thymic tissue. Unlike liposarcomas, thymolipomas tend to conform to adjacent anatomic structures and typically appear in the anterior mediastinum. Thymoliposarcomas are liposarcomas arising from the thymus.
Lipoleiomyomas are benign tumors that are variants of leiomyomas and are most often found in the uterus. Extrauterine locations have been reported on rare occasions, with most occurring intraabdominally. Authors of a single case report noted a tumor arising from the middle mediastinum.1