An Unusual Cause of Precordial Chest Pain

Extraskeletal chondrosarcoma in anterior mediastinum is very rare. A 45-year-old male patient was admitted to the hospital with precordial chest pain. A large and well-shaped mass in the anterior mediastinum was seen radiologically, and there was a clearly compression of the heart by the mass. The lesion was totally resected, and extraskeletal mediastinal chondrosarcoma was histopathologically diagnosed. We aimed to present and discuss the radiologic, clinic, and histopathologic features of unusual presentation of extraskeletal chondrosarcoma in a case. 1. Background Chondrosarcoma is a malignant mesenchymal tumor arising from cartilage-forming tissues involving the bones (bone chondrosarcoma) or the soft tissues (extraskeletal chondrosarcoma). Bone chondrosarcoma usually affects middle-aged to elderly adults, and the pelvic bones, ribs, shoulder girdle, and long bones are the most common locations. Extraskeletal chondrosarcoma usually affects the deep soft tissues of the extremities and the region of head and neck [1, 2]. Extraskeletal chondrosarcoma in anterior mediastinum is very rare. We present a patient with extraskeletal chondrosarcoma in anterior mediastinum, which was located on the heart. 2. Case Presentation A 45-year-old, nonsmoker male was admitted to the hospital with precordial chest pain. Blood tests results were normal. Chest roentgenogram was initially thought to be normal. But a masslike opacity was seen on the heart (Figure 1). Thorax computed tomography (CT) and magnetic resonance (MR) imaging demonstrated a large and well-shaped mass in the anterior mediastinum and clearly compression of the heart by the mass (Figure 2). Figure 1: Posteroanterior and lateral chest radiography showing a shadow which superimposed on the shadow of his heart. Figure 2: Thorax CT and MRI showing the large, encapsulated, well-defined anterior mediastinal mass lesion. The mass lesion was obviously compressing the heart. Pulmonary function tests revealed normal spirometric values. The fiberoptic bronchoscopy was performed, and it was normal. Whole-body PET-CT with low-dose CT protocol was performed before the surgery, and there was no F18-fluorodeoxyglucose (FDG) uptake in lesion or any part of body. The surgical excision was planned. There was no relationship between the mass and adjacent structures. An encapsulated mass was totally removed. Pathological examination revealed a well-differentiated chondrosarcoma with chondrocyte atypias and neoplastic chondrocytes (Figures 3 and 4). No recurrence was seen in the 2-year followup. The approval of patient and