Rupture of anterior mediastinal mature teratoma in a 16-years-old girl: A case report

Abstract

Background: Mediastinal teratomas are rare neoplasms, accounting for <10% of all mediastinal tumors. The most commonly involved site is the anterior mediastinum. In prepubertal patients, teratomas account for 58% of all germ cell tumors in the mediastinum and are usually asymptomatic in 50% of children. Tumor rupture is rare and can cause pleural effusion.Case description: A 16-year-old girl came to the hospital with the main complaint of shortness of breath three days ago. Physical examination found an increase in the respiratory rate and pulse rate, asymmetric chest wall movement, no right pulmonary breath sounds, and an increased right vocal fremitus. Blood laboratory tests show an elevated sedimentation rate. CT imaging showed a well-defined, flat edge tumor mass with heterogeneous density in solid, cystic, fat, and calcified. The tumor measured 14.8 x 10.0 x 17.4 cm, in the anterior to the medial mediastinum, urge the heart and other mediastinal organs to the left, the collapse of the right lung's inferior lobe, and right fluidopneumothorax. The tumor was suspicious of a teratoma. Right posterolateral thoracotomy and tumor resection was performed. Macroscopically, there was a multicystic tumor mass measuring 15.5 x 14.0 x 9.0 cm with an incomplete capsule. Microscopic examination of the tumor mass showed 3 components of the germ layer, namely ectodermal, mesodermal and endodermal. No immature component appears.Conclusion: Based on clinical features, CT imaging, macroscopic and routine histopathological examinations this case was concluded as rupture of mature teratoma.