A High Serum-Ascites Albumin Gradient and Mediastinal Fibrosarcoma: A Case Report

Ahmad Hormati, Maryam Jameshorani, Saeid Sarkeshikian, Mohammad Reza Ghadir, Faezeh Alemi


Accumulation of free fluid in the peritoneal cavity is called ascites. The first step in identifying its etiology is to determine the serum-ascites albumin gradient (SAAG). According to this parameter, a high SAAG is regarded as a gradient greater than 1.1 g/dL. This condition has some differential diagnoses such as liver cirrhosis, Budd-Chiari syndrome, heart failure, and idiopathic portal fibrosis.

In the present article, we present a young man with abdominal distention due to a high SAAG. Further evaluation of the abdominal and thoracic cavity revealed a mass in the posterior mediastinum, which had compressed the inferior vena cava and left atrium and led to Budd-Chiari syndrome. Evaluation of the biopsy sample showed fibrosarcoma.

Mediastinal fibrosarcomas, though rare, should be considered in the differential diagnosis of mediastinal masses.


Ascites, Budd-Chiari Syndrome, Fibrosarcoma

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