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Case Reports
. 2014 May 19:2014:bcr2014203835.
doi: 10.1136/bcr-2014-203835.

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

Manoj Kumar Pattnaik  1 , Paresh Chandra Majhi  1 , Anil Kumar Nayak  2 , Debadutta Senapati  2
Affiliations
Case Reports

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

Manoj Kumar Pattnaik et al. BMJ Case Rep. .

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.

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Figures

Figure 1
Figure 1
Chest radiograph showing a cavity with fluid level in the right-upper lobe.
Figure 2
Figure 2
Contrast-enhanced CT of the thorax showing a heterogeneously enhancing mass lesion with areas of fat density and multiple coarse calcifications in the anterior mediastinum extending into the right lung and a lobulated air-containing cavity in the anterior segment of the right-upper lobe.
Figure 3
Figure 3
The mass containing hair, fatty tissue, cartilages and sebaceous material.
Figure 4
Figure 4
Photomicrograph showing mature cystic teratoma, keratinised-stratified squamous epithelium and pilosebaceous unit.
Figure 5
Figure 5
Photomicrograph showing pulmonary alveoli with alveolar macrophages, multinucleated giant cells.
See this image and copyright information in PMC

References

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