A rare presentation of a huge mature mediastinal teratoma with right lung cavitation

Abstract

A school-going child presented with fever and productive cough for a short period, which after laboratory and radiological survey was diagnosed as mediastinal teratoma with lung cavitation. Preoperatively the exact cause of lung pathology could not be established, although more common causes prevalent in this zone such as, tuberculosis and lung abscess were excluded. Surgical treatment was planned and excision of the mediastinal mass with segmentectomy of the right-upper lobe carried out through median sternotomy. Mature teratoma is the most common primary germ cell tumour of the mediastinum accounting for 60–70% of all mediastinal germ cell tumours. On very rare occasions it involves the adjacent lung, usually the left lung, producing secondary changes inviting suspicion of a separate lung pathology. Here we present a rare case of a huge mature mediastinal teratoma with secondary right lung cavitation.

Anterior Mediastinal Benign Teratodermoid Tumour With Intraparenchymal Extension Through Cystobronchial Connection: A Rare Case Report

“…Tissues derived from at least two germ layers are needed for pathological diagnosis. According to the degree of differentiation, it is divided into mature teratoma and immature teratoma [3]. Tumour necrosis and superinfection commonly lead to fistula formation [4].…”

“…These tumours are commonly asymptomatic, and compression symptoms are rare due to protrusion (left side > right side). Rare presentation of mediastinal germ cell tumour includes compression, rupture into lung parenchyma, and fistula to bronchus and skin [2,3]. We are presenting a case of mediastinal mass (mature cystic teratoma) with intraparenchymal extension through cystobronchial connection with right middle lobe bronchus, managed with mediastinal mass excision with right middle lobectomy.…”

Teratoma as unusual cause of chest pain, hemoptysis and dyspnea in a young patient

“…Approximately 15% of primary mediastinal masses are derived from germinal tissue in adults and up to 24% in children [ 1 ]. Sporadic cases have been described [ [2] , [3] , [4] , [5] , [6] ]. Most of them present in anterior mediastinum, only up to 8% -in posterior mediastinum [ 2 ].…”

Surgical treatment of giant mediastinal tumors

“…The malignant tumors consisted of nine liposarcomas,[ 4 - 13 ] five thymomas (Masaoka Stage II-III),[ 14 - 18 ] three schwannomas,[ 19 , 20 ] one gangliocytoma,[ 21 ] one angiolipoma,[ 22 ] one endodermal sinus tumor,[ 23 ] one epithelioid angiosarcoma,[ 24 ] one stromal tumor,[ 25 ] and one solitary fibrous tumor. [ 26 ] The benign tumors included five mature teratomas,[ 27 - 31 ] five schwannomas,[ 2 , 32 - 35 ] five t hymolipomas,[ 36 - 40 ] two leiomyomas,[ 41 , 42 ] two thymomas (Masaoka Stage I),[ 43 , 44 ] one pericardial cyst,[ 45 ] one germ cell tumor,[ 46 ] one cavernous hemangioma,[ 47 ] one lymphangioma,[ 48 ] and one pericardial paraganglioma. [ 49 ]…”