Mediastinal Tumor (Teratoma) vs. Pigeon Chest

Left picture: The sternal protrusion is caused by a huge mass lying in the anterior mediastinum. Right picture: In this case the diagnosis is an isolated pigeon chest (pectus carinatum). Left picture: The enlargement of the left hemithorax and the one-sidedness of the mass speaks against a thymus hyperplasia of the newborn and young infant; rather, the mass is caused by a congenital tumor, in this case, a teratoma. Right picture: Rarely, the sternal protrusion as leading sign of an isolated pigeon chest may be encountered more cranially. Age, missing mediastinal opacity, and typical site of protrusion allow the diagnosis of an autochthonous pectus carinatum in the presented case.

In both patients a protrusion of the sternum has been observed on clinical presentation. Left picture: In this patient the protrusion of the sternum is visible on a lateral chest x-ray at the top. The underlying pathologies leading to a pigeon chest deformity are different as far as the children´s age and the precise site of the sternal protrusion in these two patients are concerned. Left picture: This patient is an infant. The sternal protrusion lies cranially. The dorsovolar chest x-ray shows a huge mass which led to an enlargement of the left hemithorax in the picture at the bottom. Right picture: In this teenager the protrusion of the sternum lies more in a caudal direction.