Tantangan Diagnostik Tumor Mediastinum Anterior pada Wanita Usia 76 Tahun: Sebuah Laporan Kasus

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Anterior mediastinal tumors remain a diagnostic challenge due to a wide range of possible differential diagnoses, the most common being lymphoma, thymoma, teratoma, and substernal thyroid mass. Large tumors can cause compression of vital structures such as the superior vena cava, airway, and pleura, producing variable clinical manifestations. Case report: A 76-year-old woman presented with dyspnea worsening over one month prior to admission, exacerbated by activity, accompanied by intermittent fever, weight loss, and epigastric pain. Physical examination revealed decreased breath sounds at the apex and medial right lung. Laboratory findings showed mild anemia and hyperthyroidism (decreased TSH with elevated FT3 and FT4). Chest radiography and CT scan revealed a large anterior mediastinal mass suggestive of teratoma, while neck ultrasound demonstrated bilateral thyroid masses with cervical-submandibular lymphadenopathy. However, pleural fluid cytology, FNAB, and core biopsy showed no evidence of malignancy. Conclusion: Anterior mediastinal tumors may lead to life-threatening complications such as superior vena cava syndrome and require a multimodal diagnostic approach. Although definitive diagnosis depends on histopathology, clinical symptoms and radiological findings play a critical role in directing the diagnostic process and guiding appropriate management.