Trichoptysis: a hairy presentation of a rare tumour

Abstract

We describe the case of a 17-year-old hairdresser who presented with haemoptysis and trichoptysis due to benign intrapulmonary teratoma and her surgical management. The clinical and radiological features of this rare tumour are reviewed and the symptom of trichoptysis discussed.

A 31-Year-Old Woman With Hemoptysis and an Intrathoracic Mass

“…53 The expectorated hair from teratomas is usually white, perhaps due to a lack of maturity of the pigment-producing cells within the tumor. 17 Detection of endobronchial hair in the absence of trichoptysis, as was the case here, has the same signifi cance (bronchial communication). 19 All intrathoracic teratomas have been shown to produce proteolytic or digestive enzymes that can lead to invasion and rupture into adjacent structures.…”

Pleural Effusion: A Rare Presentation of Mature Teratoma in a Young Patient

“…If present, symptoms are related to mechanical effects of compression and may include cough, breathlessness, and chest pain. Rarely does it present as trichoptysis, which is the result of communication between the tumor and airways [ 6 ]. Fistula resulting from pericardial or vascular erosions can have severe consequences, including superior vena cava syndrome or brachial plexus neuritis.…”

Infectious and Non-Infectious Diseases Causing the Air Crescent Sign: A State-of-the-Art Review

“…A follow-up image obtained 2 years later (b) demonstrates a mass with spiculated borders in the posterior aspect of the largest bulla, corresponding to the growth of the small nodule seen previously inside the smaller bulla. Also note the parenchymal interstitial thickening, suggestive of carcinomatous lymphangitis, and bilateral pleural effusion males and females [55]. The presenting symptoms are variable and usually not specific.…”

“…Teratoma is a common tumor of the mediastinum; primary malignant teratoma of the lung is exceptionally rare. To substantiate the diagnosis, one must exclude the most likely alternative of lung metastasis or direct extension from a teratoma arisen in mediastinum [53][54][55].…”

“…The presenting symptoms are variable and usually not specific. A highly suggestive symptom of an intrapulmonary teratoma is the expectoration of hair (trichoptysis), which occurs in 13% of cases and signifies direct communication between the teratoma and the tracheobronchial tree [53,55,56]. Although the typical CT aspect of a teratoma is a heterogeneous, lobulated mass containing soft tissue, fat, fluid, and/or calcium, this entity may appear as a cavitary lesion or consolidation.…”