Korean J Radiol.  2000 Sep;1(3):162-164. 10.3348/kjr.2000.1.3.162.

Teratoma with Malignant Transformation in the Anterior Mediastinum: A Case Report

• Jung JI
• Park SH
• Park JG
• Lee SH
• Lee KY
• Hahn ST

• KMID: 877077
• DOI: http://doi.org/10.3348/kjr.2000.1.3.162

Abstract

Malignant transformation of teratoma in the anterior mediastinum is rare; the mass usually has a long history and is seen in older patients. We report a case of teratoma with malignant transformation in the anterior mediastinum, complicated by rupture. CT revealed a lobulated, inhomogeneous cystic mass with a fat com-ponent and wall calcifications. The lateral wall was disrupted and consolidation in the adjacent left upper lobe was noted, suggesting rupture. A heterogeneously enhanced solid portion, obliterating the fat plane between the mass and the great vessels was present in the medial aspect of the mass, and pathologic examina-tion demonstrated the presence of adenocarcinoma.

Keyword

Mediastinum, neoplasms; Mediastinum, CT; Teratoma, malignant

MeSH Terms

Adenocarcinoma/pathology
Human
Male
Mediastinal Neoplasms/pathology/*radiography
Mediastinum/pathology
Middle Age
Rupture, Spontaneous
Teratoma/pathology/*radiography

Figure

• 

  Fig. 1 A-49-year-old man and teratoma and malignant transformation. A. Contrast-enhanced CT scan indicates the presence in the mediastinum of a lobulated low attenuated mass containing a fat component (HU =-45) (white arrows) and wall calcifications. The lateral wall of the mass is focally disrupted and consolidation with the fat component in the adjacent left upper lobe is noted (arrowheads). A heterogeneously enhanced solid portion is observed in the medial aspect of the mass, and this obliterates the fat plane between the mass and the main pulmonary artery (black arrows). B. CT scan obtained at the origin of the great vessels shows an inhomogeneously enhanced solid portion which invades the mediastinal great vessels (white arrows) and was pathologically proven to be adenocarcinoma (★right bracheocephalic artery, ✱left common carotid artery, *left subclavian artery). C. Light microscopic examination demonstrates that part of the resected mass is composed of mature fat (F), chrondroid cartilage (C), and glandular tissue (arrows) (×20, Hemtoxyline-eosin stain). D. Light microscopic examination demonstrates the medial part of the mass, in which poorly differentiated adenocarcinoma crosses the fibrous outer wall (W) (×20, Hematoxyline-eosin stain).

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