Single institutional experience with mediastinal mature cystic teratoma: An analysis of 17 cases

Abstract

Background: Mature cystic teratoma is a rare benign tumor of the mediastinum. Objective: We aimed to evaluate clinical, imaging, and pathological characteristics and treatment of the patients with mediastinal mature cystic teratoma. Methods: We reviewed the records of pathology department from the beginning of 2002 to the end of 2014. Results: The present study included 14 female and 3 male patients with mean age of 28.5 years. Four patients (23.5 %) were asymptomatic. Chest X-ray was normal in three patients (17.6 %). Computed tomography of the thorax showed fat attenuation and calcification in 52.9 % and 41.2 % in the lesions, respectively. Multicompartmental location was observed in 2 (11.8 %) patients. There were associated pleural effusion in four patients (23.5 %), both pleural and pericardial effusion in one patient (5.9 %), and compressive atelectasis in three patients (17.6 %). Surgical excision was performed through median sternotomy in 6 and thoracotomy in 11 patients. There was postoperative mortality in one patient. While tumor exhibited a variety of mature tissues from the three germ cell layers in 6 patients (35.3 %), there was a variety of mature tissues from the two germ cell layers in 11 patients (64.7 %). The most common components were skin and skin appendages in ectoderm, cartilage and adipose tissue in mesoderm, and respiratory epithelium and gastrointestinal epithelium in endoderm. Conclusions: Mature cystic teratoma is a rare tumor of the mediastinum. The diagnosis of this tumor is difficult through non-invasive investigations and preoperative biopsies. Surgical resection requires both diagnosis and treatment of mature cystic teratoma.