Large mediastinal/thoracic benign teratoma presenting with haemoptysis: Report of a case and review of the literature

Abstract

The mediastinal teratomas can grow to a large size before becoming symptomatic. The symptoms are usually due to the compression of adjacent structures. A computed tomographic scan of the chest is the investigation of choice for making a provisional diagnosis and planning for further management. Removal of large mediastinal/thoracic teratoma can be associated with various intraoperative and postoperative complications, which can be life-threatening sometimes. We operated on a patient with a large mediastinal mass extending into the right thoracic cavity up to the costo-phrenic angle. The postoperative period was eventful and required judicious intensive care. The patient eventually recovered with conservative treatment. A literature search was done on PubMed using the keywords benign mediastinal teratoma. Case series/original articles published in the last two decades, that is, after the year 2000, were evaluated. As per the review of the literature, the prevalence of benign mediastinal teratoma may be higher in eastern countries. Thoracoscopic surgery is the preferred modality except for cases with adhesions or infiltration into surrounding structures.

Keywords: Benign mediastinal teratoma; haemoptysis; mediastinal shift; postoperative complications; surgical excision.

Figure 1

(a) Chest X-ray showing a large mediastinal mass extending into the right thoracic cavity in AP view; and (b–d) CT chest showing a large thoracic cystic mass in the axial, sagittal and coronal planes, respectively

Figure 2

(a) Intraoperative image showing cyst wall adherent to the middle and lower lobes of the right lung, (b) intraoperative image after removal of the thoracic mass arising from the mediastinum and (c) postoperative chest X-ray in AP view

Figure 3

(a) Gross photograph of the mass showing lobules of adipose tissue, hair tuffet, and areas of haemorrhage in the cyst wall. (b and c) Photomicrograph showing mature squamous epithelium with adnexa, salivary glands and islands of mature hyaline cartilage