Mediastinal Mature Teratoma Revealed by Empyema

Abstract EN

Teratomas are germ cell tumors, manifested with a great variety of clinical features; the most common extragonadal site is the anterior mediastinum.

In this case, we report the patient with a large mature mediastinal teratoma with several components of ectodermal and endothermal epithelium.

A 24-year-old female patient presented with history of persistent chest pain and progressively aggravating dyspnea for the previous 3 months.

A chest X-ray showed a large opacity of the entire left hemithorax.

Transcutaneous needle aspiration revealed a purulent fluid.

The tube thoracostomy was introduced and the effusion was evacuated.

Some weeks later, patient was seen in emergency for persistent cough and lateral chest pain.

CT scan revealed a mass of the left hemithorax.

The mass showed heterogeneous density, without compressing mediastinum great vessels and left hilar structures.

Lipase value was elevated in needle aspiration.

The patient underwent a total resection of the mediastinum mass via a left posterolateral thoracotomy.

Microscopy revealed a mature teratoma with cystic structures.

The patient subsequently made a full recovery.

This case provide benign mediastinal teratoma with total atelectasis of left lung and elevated lipase value in needle transcutaneous aspiration; this event is explained by pancreatic component in the cystic tumor.

Total removal of the tumor is adequate treatment for this type of teratoma and the prognosis is excellent.