Secondary Pigeon Breast, Mediastinal Tumor vs. Pigeon Breast-like Thorax Deformity
Left picture: Surgery revealed the presence of a cystic lymphangioma expanding toward the right side which was confirmed histologically. The cyclic boundary of the mass in the images is suggestive of a cystic lymphangioma, and the unusually high and early manifesting pigeon chest is the effect of the space-occupying process of this mediastinal tumor. Right picture: It is a rare type of a pigeon breast-like thoracic deformity which is already recognizable in a toddler. It is not due to an intrathoracic mass as in the contralateral case report nor due to a primary disorder as a typical primary pigeon chest with clinical manifestation in teens; but, caused by a non-operative treatment of an omphalocele. The missing influence of the abdominal organs on the shape of the thorax apperture and the lower sternum has led to this deformity.
Young infant with pigeon chest deformity in the upper sternum and toddler with pigeon chest deformity in the lower sternum. Left picture: Thorax image in two planes: The side view (at the top) shows a distinct protrusion of the sternum in the cranial half which would be clinically also recognizable. Unexpectedly, a shadow is present with a round boundary toward the bottom covering the upper and middle area of the thorax in the dorso-ventral direction. In the front view (at the bottom) on the right side of the illustrations the mass which is confined polycyclically at its side projects into the upper and middle mediastinum, while the left hemithorax is bigger. Right picture: Oblique view from the front to a 5.4 years old toddler. The trunc and particularly the visible chest are slender and narrow. The middle part of the thorax with an acute rib bow and the lower part of the sternum have a keel-like deformity and are prominent.