History

A 63-year-old Thai man with hereditary spherocytosis presented with pruritus of his legs and subsequently found to have a raised serum ferritin of 1638 µg/L. He had previously not required transfusional support. A referral was made to the gastroenterologists for investigation of iron overload. The HFE gene was not detected, thereby excluding hereditary haemochromatosis.

A T2* MRI scan was performed to identify areas of high iron load as part of the transfusion programme at the Royal Bournemouth Hospital for patients with myelodysplastic syndromes. This showed a large mass in the posterior right chest and a 3 cm×4 cm mass in the inferomedial left chest (figures …