A large ruptured mediastinal teratoma

Abstract

Introduction: Mediastinal teratomas are the most common type of mediastinal germ cell tumor. Most patients with mediastinal teratomas remain clinically silent. However, these teratomas occasionally rupture into the thoracic cavity, causing severe complications; surgical intervention is always required for ruptured teratomas. Herein, we report that case of a large anterior mediastinal teratoma that ruptured into the pleural cavity and caused a lung infection, pleural effusion, and subsequent mediastinitis. Case Report: A 29-year-old man presented with rapidly progressive dyspnea and chest pain. Chest radiography revealed a large opacity in the entire right hemithorax. A thoracostomy tube was introduced into the right pleural cavity, and 200 mL of purulent fluid was evacuated. Thoracic computed tomography (CT) revealed a mass in the right hemithorax compressing the adjacent structures. The patient underwent total resection of the mediastinal mass via right posterolateral thoracotomy. Intraoperatively, the chest cavity was filled with adhesions and pus. The teratoma ruptured and adhered to surrounding structures. Postoperatively, the patient recovered completely. Microscopy revealed a mature teratoma. Conclusion: Ruptured mediastinal mature teratoma is a serious complication. Once it is diagnosed, early surgical excision should be performed to reduce rupture-related complications.