Wegener's granulomatosis presenting as mediastinal soft tissue mass invading the tracheal wall

Wegener's granulomatosis (WG) is a clinicopathologic entity of unknown caus e characterised by a necrotising granulomatous vasculitis affecting multipl e organs, especially the upper and lower respiratory tracts, lung and kidne y. The lung is the most frequently, and sometimes the only involved organ. Single or multiple nodules, with or without cavitation, are the most common pulmonary manifestations in WG, but mediastinal involvement is atypical. T he sole tracheal involvement is rare and hilar and mediastinal involvement has been thought not to be part of the clinical feature. We experienced a r are case of WG presenting as paratracheal mediastinal lesions with tracheal wall invasion, which responded dramatically to corticosteroid treatment. W e present this case with a review of the literature.