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Clinical presentation:
Adult male with precordial systolic murmur.

There is a bulge on the left mediastinal margin above the left ventricle with its centre of radius on the pulmonary outflow. The heart is large for a young adult, but the aorta seems undilated. There is no rib notching. There is no pulmonary plethora. The pulmonary vessels are undersized, if anything.

[addition]

[Differential]

cases that might resemble this pathology

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[View large image] Metastasis, (case report) [View large image] Thymoma (case report)
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[London South Bank U.]

IDM Sept 2006