{"ops":[{"insert":"A 9 year old boy presents with mild facial swelling for 2 weeks, in association with a nonproductive cough. There was no history of fever, headache, rhinorrhea, or pruritis.\n\nHis mother had taken him to a primary care practitioner 1 week ago, who had subsequently prescribed antihistamines. These had not relieved his symptoms.\n\nHis mother mentions that he has also been somewhat tired and lethargic for the last couple of months.\n\nHis birth, medical, surgical and family histories are completely unremarkable. A full blood count, urinalysis, renal functions, and serum electrolytes are all found to be normal\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-164_en.png"}},{"insert":"\n"}]}
2
Investigate
Chest X-Ray
{"ops":[{"insert":"There is a large mass in the superior mediastinum, causing mediastinal deviation towards the right.\n"}]}
MRI + MRA Thorax
{"ops":[{"insert":"MRI reveals the presence of a 6.2 x 5.3 x 5.1 cm homogenous soft-tissue mass in the superior mediastinum compressing the superior vena cava (SVC). \nThe mass is hypointense in T1 images and slightly hyperintense in T2 weighted images.\nMRA shows partial thrombosis of the SVC.\n"}]}
