Mediastinal mature cystic teratoma in a child: A case report study

Abstract

Introduction: A mediastinal teratoma is a very rare disease, in which a relatively large mass grows in the space between the two lungs. Although it is a congenital abnormality, it is diagnosed late in the second or third decade. It could be benign or malignant, symptomatic or asymptomatic.

Presentation of case: A five-year-old child presented with an acute respiratory distress episode due to an acute infection, unresponsive to first-line antibiotics and had a history of similar recurrent pulmonary infections. On imaging, the patient showed an abnormal mediastinal mass which was speculated to be a hydatid cyst or abscess; however, it was later diagnosed during surgery as a mature mediastinal cystic teratoma.

Discussion: Mediastinal tumors are slow-growing tumors that are mostly benign and asymptomatic, but sometimes they may grow, reaching a state where they can affect the neighboring anatomical structures, causing symptoms, which may lead to misdiagnosis.

Conclusion: Teratomas, as a differential diagnosis, should be considered in children with recurrent pulmonary infection and radiological findings that resemble masses in the chest. This emphasizes on the importance of performing detailed radiological and lab investigations to set an appropriate diagnosis to ensure a better treatment and prognosis.

Keywords: Case report; Hydatid cyst; Lung abscess; Mature teratoma; Mediastinal tumors; Pediatric.

Fig. 1

The first and second CT scan with contrast, showing the position of the mass and the neighboring anatomical structures.

Fig. 2

The mass after excision.

Fig. 3

A histological overview from the mass showing: 1. Pulmonary epithelial, 2. prickle cell layer, 3. pancreatic tissues, 4. connective tissues with chondrocytes.

Fig. 4

A histological overview of the mass showing: 1. prickle cell layer, 2. connective tissues with chondrocytes.