An Intrapulmonary Cystic Teratoma: As a Cavitary Lung Lesion

Abstract

We report a rare cause of lung cavities, occurring in a patient with intrapulmonary cystic teratoma. Computed tomography (CT) provided us more detailed informations about the tumor characteristics containing fat and calcification , which could not be distinguished on the plain radiographs.ln addition, CTscans clearly demonstrated the dilated anterior segmental bronchus of the left upper lobe entering the posterior aspect ofthe cavity. We recently experienced this rare condition in a 42-year -이 d man , manifested as a cavitary lung mass radiologically. Computed tomography (CT) provided us more informations about the characteristics of the tumor. CASE REPORTSAn acutely il l-i ooking , 42 -year -이 d man presented with fever , progressive dyspnea and chest pain which appeared two weeks ago. He was healthy until four years ago, when he suffered from pulmonary tubercu- Chest radiographs showed hydropneumothorax at the left side and a relatively thick-walled cavitary mass with a p 이 ypoid protrusion within the cavity at the left upper lobe. The diagnostic thoracentesis of hydropneumothorax revealed the grossly purulent fluid with the pH of 6.8 and the glucose level of less than 5 mg/dl , which prompted closed thoracotomy. Culture and cyt이 ogical examination of the empyemic fluid failed to identify a specific organism or celiular components. Chest radiographs obtained after closed thoracotomy more clearly demonstrated the cavitary mass at the left upper lobe (Fig. 1a). On CT scans , the cavity was located at the anterior segment of the left upper lobe with a portion of fungating mass which had several different tissue components including fat and calcification (Fig. 1 b). In addition , CT scans clearly demonstrated the dilated anterior segmental bronchus of the left upper lobe enteri ng the posterior aspect of the cavity (Fig. 1 C) .At thoracotomy , there was a severe , diffuse adhesion in the left pleural cavity containing pus, which urged the surgeon to perform a pleuropneumonectomy. About 5-cm sized mass was embedded in the anterior segment of the left upper 101갯 . Although there were some adhesions, it was relatively easy to separate the tumor with the mediastinum which was intact.The cut section ofthe specimen revealed the 4.6 X 4 X 3 cm -sized cavity with an internaliy protruding multino-