Mediastinal Benign Mature Teratoma in Young Girl, Catastrophic Delayed and Complications of Surgery: A Case Report

Abstract

BACKGROUND: Teratomas are the most common of germ cell tumor and have different epidemiology, histology, and biology than the others. These tumors occur equally in men and women are generally benign, occur in the mediastinum and compromise approximately 20% of anterior mediastinal masses. All forms of these tumors have a peak incidence in young adults.
 CASE REPORT: A huge mediastinal teratoma present in young girl 15 years old, a tumor located in the right chest with mass compression effect to spine, heart, and lung, produce prolong symptoms of dyspnea and chest pain. Delayed clinical presentation influences to post-operative complications such as prolong atelectasis, rupture of tumor mass which spoiled of tumor contents, empyema, and sepsis.
 CONCLUSION: Mediastinal mature teratoma with the delayed clinical presentation will give technical difficulties for resection and increase the risk of post-operative complications.

Ruptured mediastinal mature teratoma with shigellosis empyema: A case report

“…Examination of tumor markers is one of the modalities that can differentiate between benign and malignant teratoma. In patients with benign mature mediastinal teratoma, serum levels of AFP and β-HCG are within the normal range [5] , [12] . Benign teratomas (pure mature teratomas) do not secrete AFP and β-HCG, so there is no increase in AFP and β-HCG levels in benign mature teratomas.…”

“…Benign teratomas (pure mature teratomas) do not secrete AFP and β-HCG, so there is no increase in AFP and β-HCG levels in benign mature teratomas. Increased AFP and β-HCG may indicate malignancy [5] , [13] . Serum levels of AFP, β-HCG, and LDH are well validated for noninvasive diagnostics of Germ Cell Tumors.…”

“…Significant elevations in serum AFP or β-HCG, each suggesting a significant component of a yolk sac tumor or choriocarcinoma, exclude the diagnosis of a pure mature teratoma or seminoma. During the diagnosis and follow-up of mediastinal teratoma, it is necessary to monitor serum AFP and β-HCG levels [5] , [14] .…”

“…Meanwhile, mediastinal teratoma is a rare neoplasm (8–13 % of all mediastinal tumors and only 1–10 % of germ cell tumors occur in the mediastinum) [4] . Mediastinal teratomas result from pluripotent germ cells that fail to migrate from the mediastinum to the gonads during the early developmental phase [5] . The incidence of teratomas is about 1 in 4000 live births [4] , [6] .…”

Mature Teratoma Revealed by an Encysted Pleural Effusion

“…Thoracic computed tomography showed typical patterns of mediastinal teratoma, with tissue, fluid, fat and calcium densities [8]. Microscopically, mature teratomas are often made of well-differentiated ectodermal (skin, hair, sweat glands and tooth), mesodermal (fat, cartilage, bone and smooth muscle) as well as endodermal (respiratory and intestinal epithelium) elements in varying proportions [9] [10].…”