LAUSR

A 33-year-old woman with intermittent chest pain for 5 months was admitted to our hospital. Physical examination showed dilated veins over the chest wall and the electrocardiogram (ECG) was normal. CT scan (Figure 1A, B) revealed a soft tissue mass (diameter of 9.0 cm) in the anterior mediastinum with compression of the superior vena cava (SVC). F-FDG PET/CT scan detected the mass that (Figure 2A-G) exhibited elevated FDG activity (SUVmax of 6.3) with intralesional necrosis, including a focal FDG activity in the SVC (SUVmax of 5.8) which indicated the involvement of the SVC. In addition, there were many lymph nodes with increased FDG activity in the neck and mediastinum (SUVmax of 3.3). Moreover, multiple focal FDG activities were noted in the vertebra, humerus, rib, and bilateral ilia (SUVmax of 9.2). The findings were suggestive of lymphoma with bone metastases. Subsequent CT-guided biopsy was performed. However, the pathology of the mass revealed an atypical thymic carcinoid (Figure 3A, B). Subsequently, the patient received radiotherapy. The mediastinal mass decreased during the next 3 months (Figure 4A, B), and the patient has partial response to the treatment.