Preoperative Embolization of a Posterior Mediastinal Lipid-Poor Angiolipoma Mimicking a Paravertebral Nerve Sheath Tumor Luis Gorospe, MD, Javier García-Poza,

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Preoperative Embolization of a Posterior Mediastinal Lipid-Poor Angiolipoma Mimicking a Paravertebral Nerve Sheath Tumor Luis Gorospe, MD, Javier García-Poza, MD, María Cristina González-Gordaliza, MD, Alberto Cabañero-Sánchez, MD, Gemma María Muñoz-Molina, MD, PhD, David Saldaña-Garrido, MD The Annals of Thoracic Surgery Volume 100, Issue 2, Pages 705-707 (August 2015) DOI: 10.1016/j.athoracsur.2014.09.076 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Axial unenhanced computed tomography image shows a homogeneous soft-tissue mass (arrow) in the left posterior mediastinum at the T3-T4 level with possible left intervertebral foramen extension. Note the absence of macroscopic focal areas of fat attenuation. The Annals of Thoracic Surgery 2015 100, 705-707DOI: (10.1016/j.athoracsur.2014.09.076) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Sagittal T1-weighted magnetic resonance image (MRI) shows a homogeneously hypointense posterior mediastinal mass (*) extending into the left T3-T4 foramen. There are no foci of high (fat) signal intensity. (B) An axial T2-weighted MRI demonstrates extension of the mass into the intervertebral foramen (*), but spinal cord compression is not seen. (C) Axial gadolinium-enhanced fat-suppressed T1-weighted MRI shows avid contrast uptake by the mass (*). There are no areas of signal decrease on this fat-suppressed sequence. Small serpiginous flow voids (representing intratumoral vessels) are seen (arrows). The Annals of Thoracic Surgery 2015 100, 705-707DOI: (10.1016/j.athoracsur.2014.09.076) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 A computed tomography-guided core needle biopsy of the mass using a coaxial technique is shown. The Annals of Thoracic Surgery 2015 100, 705-707DOI: (10.1016/j.athoracsur.2014.09.076) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Thoracic aortogram demonstrates a hypertrophic and tortuous left superior bronchial artery, which supplied the mediastinal mass. (B) Postembolization aortogram shows devascularization of the mass. The Annals of Thoracic Surgery 2015 100, 705-707DOI: (10.1016/j.athoracsur.2014.09.076) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions