A case of fibrosing mediastinitis manifesting recurrent nerve palsy

: A 68 year-old man was referred and admitted to our hospital because of hoarseness due to recurrent nerve palsy and an anterior mediastinal tumor detected on chest CT. Chest CT showed a low-density tumor surrounding the aorta and branching arteries. Chest MRI revealed a low-intensity tumor in both T1- and T2-weighted images. The tumor was adjacent to the heart and aorta in the upper anterior mediastinum. A biopsy was performed under minimally invasive video-assisted thoracic surgery (VATS) and a diagnosis of fibrosing mediastinitis was made histopathologically. Oral prednisolone treatment markedly reduced the tumor and improved not only abnormal laboratory data such as C-reactive protein, but also the hoarseness. We report herein that steroid monotherapy was successful in treating a case of fibrosing mediastinitis manifesting recurrent nerve palsy.