Intrapulmonary cystic teratoma mimicking malignant pulmonary neoplasm

Abstract

Benign cystic teratoma of lung is an extremely rare tumour, which was first described in literature by Mohr in 1839. Intrapulmonary teratoma is thought to be a derivative of the third endo-dermal pharyngeal pouch, which is an anlage of the thymus. The authors present a rare case of mature cystic teratoma in a young male involving the right upper lobe of the lung. Diagnosis is often missed and patients are treated for various infectious conditions. Treatment is complete resection for both benign and malignant teratomas and carries excellent prognosis. Benign cystic teratoma, if not excised may cause grave complications like life-threatening haemoptysis or malignant transformation with metastatic disease.

Figure 1

Roentgenogram of the chest showing right upper lobe opacity.

Figure 2

CT scan of the chest (axial and coronal views) showing the large parenchymal mass measuring 8.5×8.9 cm abutting the aortic arch and SVC with surrounding area of pulmonary consolidation.

Figure 3

Bronchoscopy revealing significant narrowing of the right upper lobe (RUL) bronchus with friable bulging mucosa (right), and RUL anterior segment necrotic mucosa with destruction of the normal airway (left).

Figure 4

Microscopy showing well-formed hair follicles along with prominent hair shaft (left), sweat glands and sebaceous glands (right).

Figure 5

Microscopy showing keratin debris in the bronchioles (left) with surrounding organising pneumonia (right).