Thoracic Tumor of Unclear Nature
A 3-year-old boy was brought to us with dyspnea, pulmonary obstruction, and fever. He was known to have tuberous sclerosis, and had undergone patch closure of a left-sided congenital diaphragmatic hernia after birth. Furthermore, he had recurring pneumonia and right convex torsion scoliosis. Virological examination identified a bocavirus infection as cause of the obstructive components. A chest radiograph obtained for diagnosis of pneumonia in the presence of dyspnea surprisingly revealed a circumscribed mass in the left lower lung. The impression on sonography, confirmed by magnetic resonance imaging (Figure), was of recurrence of the diaphragmatic hernia with intrathoracic protrusion of the left kidney through the retroperitoneally situated Bochdalek triangle. The kidney, which was found to have a long vascular pedicle, was simply and successfully returned to its previous normal location via thoracoscopic herniorrhaphy. An ectopic kidney in the thorax in association with Bochdalek hernia is an extremely rare event, and occurrence of the typical symptoms should prompt immediate surgical correction.
Prof. Dr. med. Stefanie Weber, Sektion für Pädiatrische Pneumologie, Klinik für Pädiatrische Nephrologie,
Transplantationsnephrologie und Allgemeine Kinderheilkunde, Universitätsklinikum Marburg, firstname.lastname@example.org
PD Dr. med. Reza Vahdad, Klinik für Kinderchirurgie, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Marburg
Franziska Meixner, Klinik für Diagnostische und Interventionelle Radiologie,
Conflict of interest statement: The authors declare that no conflict of interest exists.
Translated from the original German by David Roseveare.
Cite this as: Weber S, Vahdad R, Meixner F: Thoracic tumor of unclear nature. Dtsch Arztebl Int 2020; 117: 734. DOI: 10.3238/arztebl.2020.0734