Ganglioneuroma vs. Dermoid Cyst
Left picture: In this patient a ganglioneuroma was actually present and confirmed by histological examination of the excised mass. Right picture: As expected, a dermoid cyst of the anterior mediastinum was found; this diagnosis had been suspected due to the described irregular calcifications (precursors of teeth in the dermoid cyst).
In both girls a paramedian mass above the heart shadow was observed on chest x-ray. Both children had no specific signs of a mediastinal tumor. Left picture: In this toddler the left-sided opacity could by localized in the posterior mediastinum by a lateral chest x-ray which is seen at the bottom. Right picture: In this schoolchild it was possible to localize the left-sided mass in the anterior mediastinum in the picture at the bottom; the mass exhibited irregular calcifications as specific structure alterations. Considering the different site and structure of the two masses on the x-rays, the unspecific history and clinical presentation, as well as the different ages, only a restricted number of pathologies are suitable for the differential diagnosis of the radiological mediastinal tumor. Left picture: Here, hardly anything but a benign neurogenic tumor has to be considered. Enterogenic cysts are usually smaller, round, and situated more paramedianly. Right picture: In this situation a benign teratoma or a thymus tumor are most probable. For a thymus hyperplasia the patient is too old.