A 78-year-old woman was referred for assessment of a non-productive cough and abnormal findings on chest roentgenogram. Physical examination showed a healthy-looking elderly woman with no abnormal chest findings. A PA chest film showed a 4 cm rounded mass just below the right hilum (Fig 1). A lateral film (Fig 2) identified a prominent mediastinal mass. Review of old films confirmed that this lesion had been present and unchanged for five years. Tomograms and a CAT scan of the thorax outlined a noncalcified mass in the retrocardiac space. At fluoroscopy, this mass was nonpulsatile. The patient declined further investigation. Two years following initial presentation, she experienced a sudden paroxysm of coughing and produced a large amount of mucoid sputum. A subsequent chest x-ray film (Fig 3, lateral view) showed that the lesion had disappeared. The patient remains clinically well with no further roentgenographic changes two years following this episode.
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