Tuberc Respir Dis.  2006 Mar;60(3):347-352.

Teratoma Presenting as An Unilateral Mediastinal Mass with Contralateral Pleural Effusion

• Ha ES
• Hur GY
• Jung KH
• Lee SY
• Jo WM
• Lee SY
• Kim JH
• Lee ES
• Shin C
• Shim JJ
• In KH
• Kang KH
• Yoo SH

Abstract

A teratoma is the most common benign germ cell tumor that develops in the mediastinum. Patients with a mediastinal teratoma are usually asymptomatic. However, a spontaneous rupture of a mediastinal teratoma into the pleural cavity or adjacent organs can cause severe chest pain, hemoptysis, acute dyspnea, etc. Complications such as recurrent pneumonia, pericardial effusion, pleural effusion and great vessel invasion can sometimes occur. We encountered a case of a patient with an abrupt onset of dyspnea after persistent shoulder pain for one month. The X-ray examinations revealed a unilateral mediastinal mass with contralateral pleural effusion. Subsequent evaluations confirmed a spontaneous rupture of the teratoma into the contralateral pleural cavity.

Keyword

Mediastinal neoplasms Teratoma pleural effusion

MeSH Terms

Chest Pain
Dyspnea
Hemoptysis
Humans
Mediastinum
Neoplasms, Germ Cell and Embryonal
Pericardial Effusion
Pleural Cavity
Pleural Effusion*
Pneumonia
Rupture, Spontaneous
Shoulder Pain
Teratoma*

Figure

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  Figure 1 Chest radiography shows a huge mass lesion in right hilar area (A), blunting of left costophrenic angle with fluid shifting (B) on admission, and near-normal findings 2 months later after surgical resection (C).

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  Figure 2 Chest computed tomography shows a 6×7 cm sized, septated cystic mass, containing a fat-like low density component in the anterior mediastinum, which insinuates between superior vena cava and ascending aorta (A). The wall of mass is enhanced and no calcification is visible. Left pleural effusion and passive atelectasis are also noted (B).

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  Figure 3 Intraoperative photographs of excised specimen (A, B) showed several fragments of yellow to brown soft tissue, measuring 4.7×3×3 cm in the largest one. The histologic findings of specimens are consistent with ruptured teratoma, and reveal adipose tissue (C), formation of pancreatic acini and islet-like stucture (D). (hematoxylin and eosin, C:×100, D:×200)

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