Intrapulmonary Teratoma Research Articles

A case report of intrapulmonary mature teratoma with aspergilloma

Introduction: Teratomas are benign germ cell tumors composed of components from the ectoderm, mesoderm, and endoderm. While germ cell tumors account for 10-20% of anterior mediastinal masses, intrapulmonary teratomas (IPTs) are extremely rare. They typically occur in the third decade of life and may present as metastasis from gonadal tumors. This study reports a rare case of a mature IPT in the right middle lobe of the lung, initially misdiagnosed as pulmonary tuberculosis and aspergilloma. Case Presentation: A 17-year-old female presented with a 4-year history of cough with sputum and two episodes of hemoptysis. Despite negative tuberculosis tests, she was treated with anti-tubercular drugs and multiple antibiotics. Imaging revealed a 5.5-cm cavitary mass in the right middle lobe containing an aspergilloma. Surgical resection was performed, and the pathology confirmed a mature teratoma with aspergilloma colonization. The patient recovered well postoperatively and showed no signs of recurrence. Discussion: Teratomas are germ cell tumors rarely found in the lungs, with fewer than 100 cases reported globally. Diagnosis is challenging due to overlapping symptoms with other conditions such as tuberculosis. In this case, the presence of an aspergilloma further complicated the diagnosis. Complete surgical resection led to the patient's recovery. Conclusion: Mature IPTs with aspergilloma are extremely rare, and should be considered in the differential diagnosis of cavitary lung lesions. Early diagnosis and surgical resection are crucial for successful treatment.

A giant intrapulmonary malignant teratoma - a rare case presentation

Germ cell tumors such as teratomas are unusual and most commonly occur in the gonads. Extra-gonadal teratomas are rare, and the thorax, especially the mediastinum, is the commonly involved extra-gonadal site. Teratoma of the intrapulmonary region is rare and often involves the left upper lobe of the lung. In this report, we describe a case of a 20-year-old male diagnosed with an intrapulmonary malignant teratoma arising from the left lower lobe. Teratomas emerging from the lungs present with vague symptoms like breathing difficulty, cough, and hemoptysis. We report this rare appearance of malignant intrapulmonary teratoma that originated from the left lower zone of the lung.

Giant Intrapulmonary Mature Teratoma with Thoracostomy Intervention: A Rare Case Report

Background: Teratoma usually found in mediastinum and rarely found in the lung. Mature teratomas are the most common histological type of germ cell tumours, followed by seminoma. First case reported by Mohr in 1839 and until now only few cases of intrapulmonary teratomas have been reported.
 Case: A man, 64-years old man, nonsmoker complains of shortness of breath since 6 months and worsened in a week. Patient had history medication for tuberculosis in 2019. Chest Contrast CT-Scan showed hypodense mass and suggestive for benign left lung tumor. TTNA were performed and suggestive for teratoma. Joint conference with several department agree to proceed with thoracostomy. Thoracostomy with wide excision been done to remove the mass and examined for anatomic pathology then confirmed for mature teratoma. During thoracostomy, we cannot removed 100% of the tumor because it adhesive with aorta and parietal pleura. Patient treated in ICU and worsens. Unfortunately, patient passed away four days later.
 Conclusion: Teratoma is rarely found inside of the lung. Early diagnosis and resection of intrapulmonary teratoma is critical to prevent complications and provide definitive treatment.

Mature Teratoma Revisited: A Rare Isolated Intrapulmonary Presentation: Case Report

Background: Intrathoracic teratoma is a form of germ cell tumors and is mostly found in the anterior mediastinum. Isolated intrapulmonary teratoma (IPT) is by far a rarity. The clinical presentation is often non-specific and radiological images – in most of the cases- is not sufficient to establish a final diagnosis. Surgical resection is the gold standard curative treatment after proper preoperative assessment. Case presentation: In this case report, we describe a case of an IPT in a 33 year old female patient, who presented with hemoptysis, and was successfully treated with right upper lobe resection. The diagnosis was histologically proven as a mature IPT. Conclusion: IPT is extremely rare. Surgical resection is the gold standard method for both diagnostic and curative purposes. Strict preoperative assessment should be performed to exclude other cases of lung masses.

Intrapulmonary Teratoma Presenting with Tricoptysis: A Case Report and Review of the Literature

Intrathoracic teratoma usually occurs in the mediastinum but rarely, these may originate from the lung. We report a case of an intrapulmonary teratoma in a 34-year-old male.

Right upper lobe intrapulmonary mature cystic teratoma. An unusual location with unusual associations and a review of the literature.

IntroductionTeratomas are rare neoplasms made up of mature embryonic germ cell layers. Extra-gonadal teratomas are rare and primarily in the mediastinum. Mature cystic teratomas (MCT) are slow-growing benign tumors accounting for a small number of mediastinal germ cell tumors. Patients with MCT are often asymptomatic, and even most symptomatic intrapulmonary teratomas present with vague and non-specific symptoms such as cough, hemoptysis, and chest pain.Case presentation and discussionA Yemeni patient presented for two years with dry cough, shortness of breath, and stitching right-sided chest pain. Plain X-ray showed pleural thickening associated with two opacities in the right lung- one located centrally in the upper lobe and another peripherally- which were confirmed with a CT scan. During right-sided decortication with resection of the two masses, extensive adhesions were found between the right pleura and the chest wall. The adhesions were released, and right-sided decortication led to the removal of the peripheral cystic mass attached to the pleura. Histopathology reported the presence of squamous epithelium lining with ectodermal components such as hair follicles, sebaceous glands, keratin debris, fatty, and fibromuscular tissue.ConclusionIntrapulmonary teratomas are rare tumors, with less than 100 cases reported in the past few years. All the reported cases are in the left lung lobes, yet our case is on the right side. Although the right-sided mature cystic teratoma is even scarcer, physicians should have a high index of suspicion for teratoma when encountering abnormal lesion in the right side of the lung confirming it either by CT or MRI.

INTRAPULMONARY TERATOMA: A RARE PRESENTATION OF BRONCHIECTASIS

TOPIC: Lung Pathology TYPE: Medical Student/Resident Case Reports INTRODUCTION: Intrapulmonary teratomas (IPT) are a rare extra-gonadal manifestation of teratomas and are a challenging diagnosis to make. We present a patient with IPT presenting with hemoptysis. CASE PRESENTATION: A 49-year-old man presented with intermittent non-massive hemoptysis throughout the previous year. Labs were normal with the exception of normocytic anemia with hemoglobin of 12.1 g/dL. CT chest with contrast revealed a necrotic mass in the central left upper lobe invading the left upper lobe bronchus and obliterating the left pulmonary artery with severe bronchiectatic changes. Multiple mediastinal lymph nodes were enlarged. Flexible bronchoscopy was performed and demonstrated occlusion of the left upper lobe with a dense, white mass, and hair-like material within the bronchus. Attempts at biopsy with the cryoprobe demonstrated friable mucosa that easily bled. No intervention was necessary as spontaneous hemostasis occurred. Attempts at forceps biopsy were unsuccessful because of dense, calcified material. As a result, the cryoprobe was used. Cryoprobe biopsies revealed inflammatory cells without evidence of malignancy. Cultures including bacterial, fungal, and AFB were negative. Lack of diagnosis, severe bronchiectasis, and recurrent hemoptysis prompted the recommendation for resection, and he underwent left thoracotomy with interpleural pneumolysis. Due to involvement of the left pulmonary artery, lung sparing surgery could not be safely achieved and ultimately required a left pneumonectomy. Final pathology was consistent with a lung teratoma. DISCUSSION: Teratomas are germ cell tumors commonly located in the sacrococcygeal region, anterior mediastinum, retroperitoneum, cranium, ovary, or gonads. Rarely they are intrapulmonary in location (1). Less than 100 IPT cases have been reported to date, and usually reported in the left upper lobe. (2,7). Patients present with chest pain, cough, fever, dyspnea, bronchiectasis, or recurrent pneumonia (5). Patients may expectorate hair (trichoptysis), which is considered pathognomonic (3). Untreated, patients are at risk of malignant transformation, tumor rupture, hemoptysis, and airway obstruction from compression. (5). CT chest shows well-defined round or lobulated masses that are smooth in contour with areas of peripheral translucency and may contain fat, calcium, or fluid (5,6). Irregular or ill-defined margins can suggest malignant transformation (4).The only definitive treatment is complete surgical resection and diagnosis is often made concomitantly from the gross pathology. Early resection is crucial in order to prevent complications (6). CONCLUSIONS: IPT is a rare cause of endobronchial obstruction and highlights the need for early bronchoscopic evaluation of hemoptysis. Early diagnosis and resection of IPT is critical to prevent complications and provide definitive treatment. REFERENCE #1: Khan J, Aslam F, Fatimi S, Ahmed R. Cough, fever and a cavitary lung lesion-an intrapulmonary teratoma. J Postgrad Med. 2005;51(4):330-1. REFERENCE #2: Faria RA, Bizon JA, Junior RS, Neto VD, Botter M, Saieg MA. Intrapulmonary teratoma. J Bras Pneumol 2007; 33: 612– 615. REFERENCE #3: Siddiqui, F.A., Jain, A., Maheshwari, V. and Beg, M.H. (2010), FNA diagnosis of teratoma lung: A case report. Diagn. Cytopathol., 38: 758-760. https://doi.org/10.1002/dc.21318Webb, W., Brant, W. E., & Helms, C. A. (1991). Fundamentals of Body CT (1st ed.). Philadelphia, PA: W. B. Saunders Company.Sasaka, K., Kurihara, Y., Nakajima, Y., Seto, Y., Endo, I., Ishikawa, T., & Takagi, M. (1998). Spontaneous rupture: A complication of benign mature teratomas of the mediastinum. American Journal of Roentgenology, 170(2), 323-328. doi:10.2214/ajr.170.2.9456938 Mardani P, Naseri R, Amirian A, et al. Intrapulmonary mature cystic teratoma of the lung: Case report of a rare entity. BMC Surgery. 2020;20:1-6. Ditah C, Templin T, Mandal R, Pinchot JW, Macke RA. Isolated intrapulmonary teratoma. J Thorac Cardiovasc Surg. 2016 Dec;152(6):e129-e131. doi: 10.1016/j.jtcvs.2016.07.056. Epub 2016 Aug 5. PMID: 27576374. DISCLOSURES: No relevant relationships by Beren Chandler, source=Web Response No relevant relationships by Garret Duron, source=Web Response No relevant relationships by Lindsey Goldberg, source=Web Response No relevant relationships by Joanna Kosko, source=Web Response No relevant relationships by Jason McClune, source=Web Response No relevant relationships by Lourens Willekes, source=Web Response

INFECTED MEDIASTINAL MATURE TERATOMA

TOPIC: Disorders of the Mediastinum TYPE: Medical Student/Resident Case Reports INTRODUCTION: Mature teratoma, a benign germ-cell tumor, commonly presents in the ovaries. Extragonadal manifestation is uncommon and rarely occurs with superimposed infection. We present a unique case of extragonadal teratoma found in the mediastinum complicated by infection. CASE PRESENTATION: A 24-year-old male with a history of asthma presented with a 3-day history of dyspnea and right rib pain radiating into the center of his chest. He reported a 30-pound weight loss in the preceding 3 months. He denied tobacco, alcohol, or recreational drug use. He previously worked as a coal miner but is now working in coastal drilling. He was afebrile and normotensive but had an oxygen saturation of 93% on room air. On examination, he had right upper lobe rhonchi with absent breath sounds in the right basilar region. Chest imaging showed complete collapse of the right middle and lower lobes, large loculated right pleural effusion within the anterior right lung base, and heterogeneity with rim enhancing fluid collection, which was suggestive of empyema. The patient had leukocytosis of 16.6k with neutrophil predominance of 14.18k. The patient was started on empiric intravenous antibiotics with vancomycin, ceftriaxone, and metronidazole. He underwent video-assisted thoracoscopic surgery with cystic mass resection from the pericardial surface and anterior surface of right lower lobe, 1600 milliliters of purulent fluid drainage, and decortication of right middle and lower lobes. Frozen section showed squamous and glandular cells. Pathology showed keratinized skin with granulation tissue, acute and chronic inflammation, and giant cell reaction consistent with infected mature teratoma. Pleural fluid's gram stain revealed 2+ PMNs and no growth in aerobic, anerobic, fungus, or AFB cultures. The patient was de-escalated to amoxicillin-clavulanate for a 14-day course and clinically improved. DISCUSSION: This case demonstrates a rare presentation of extragonadal mature teratoma in the mediastinum. Mediastinal teratomas occur from 20 to 40 years old with clinical symptoms of cough, chest pain, trichoptysis, and fever. Possible complications are infection, rupture, malignant transformation, and paraneoplastic anti-N-methyl-D-aspartate receptor (anti-NMDA receptor) associated limbic encephalitis. Infected mature teratomas are uncommon. Reported infectious organisms include Salmonella enterica, Escherichia coli, Mycoplasma pneumonia, Staphylococcus aureus, Staphylococcus agalactiae, and Haemophilus influenza. Proposed pathogenesis is due to the release of proteolytic enzymes from pancreatic and/or intestinal mucosal tissues in the tumor leading to inflammation and eventual infection. CONCLUSIONS: Teratoma rarely presents with superimposed infection, which may be complicated by rupture. Definitive management is surgical excision of teratoma and antibiotic targeting the organism. REFERENCE #1: Lee WL, Yen MS, Tseng JY, Yu KW, Wang PH. Mature teratoma with secondary infection: case report. Changgeng Yi Xue Za Zhi. 1999 Jun;22(2):339-43. PMID: 10493045. REFERENCE #2: Li C, Lin F, Liu C, Hai Y, Liu L. Intrapulmonary teratoma misdiagnosed as aspergilloma. Thorac Cancer. 2018;9(2):328-329. doi:10.1111/1759-7714.12566 REFERENCE #3: Tian Z, Liu H, Li S, et al. Surgical treatment of benign mediastinal teratoma: summary of experience of 108 cases. J Cardiothorac Surg. 2020;15(1):36. Published 2020 Feb 17. doi:10.1186/s13019-020-1075- DISCLOSURES: No relevant relationships by Ashley Anselene, source=Web Response No relevant relationships by Asma Balobaid, source=Web Response No relevant relationships by Shu Xian Lee, source=Web Response No relevant relationships by Rebecca Reece, source=Web Response

Intrapulmonary mature teratoma: case report of an exceptional entity

Teratomas are tumors consisting of tissues derived from more than one germ cell line. Criteria for pulmonary origin are exclusion of a gonadal or other extra-gonadal primary site and origin entirely within the lung. The intrapulmonary teratoma (IPT) is a rare type of teratoma extra-gonadal which often presents with nonspecific symptoms and wrongly can be diagnosed as other diseases. Here we report a patient with IPT who was initially misdiagnosed as pulmonary aspergilloma. We report a case of mature pulmonary teratoma in a 22-year-old male with no toxic habits, treated in 2007 for smear-positive pulmonary tuberculosis, presenting progressively for 1 year, with a left chest pain, intermittent episodes of cough and hemoptysis, and dyspnea. A computed tomography (CT) chest scan showed a heterogeneous tumor with cavitary lesion in the left upper lobe. The patient had a left upper lobectomy with complete resection of the mediastinal mass. The patient is currently in good general condition, and does not present any complications or recurrence and thyroid function was normal during the long term follow up. Preoperative diagnosis of IPT is not always possible and is usually misdiagnosed early on due to its rarity, nonspecific and vague symptoms, normal lab results, and indistinguishable chest x-ray results. We report a case of intrapulmonary teratoma in a 22-year-old man and review the relevant literature.

Aspergilloma or intrapulmonary teratoma - time to rethink

Intrapulmonary teratoma (IPT) is a rare type of extra gonadal germ cell tumor which can often be misdiagnosed due to its non-specific presentation. Complete surgical resection should be done because of its malignant potential. We report a case of 33 years old female previously treated as tuberculous osteomyelitis of sternum. She presented with chest pain and sudden hemoptysis. Based on the radiological picture she was diagnosed as complex aspergilloma of lung with a thick walled cavity. Hemoptysis was controlled with supportive management. On surgery right upper lobe was densely adherent to the anterior chest wall. Exploration of the cavity revealed a 6×4 cm whitish mass with non-pigmented hair. Right upper lobectomy and wide excision of the mass was performed. Histopathology was consistent with the diagnosis of IPT with no malignant cells.

Intrapulmonary mature cystic teratoma of the lung: case report of a rare entity

BackgroundIntrapulmonary teratoma (IPT) is a rare type of extra gonadal teratoma which often presents with non-specific symptoms and can be misdiagnosed as other diseases. Here we report a patient with IPT which was initially misdiagnosed as lung hydatid cyst versus abscess.Case presentationWe report an intrapulmonary teratoma in a 27-year-old female presenting with persistent chest pain and dyspnea since a few years prior to her admission with associated symptoms of cough and fever. Chest x-ray only showed left side massive pleural effusion and computed tomography scan of the lungs was suggestive of hydatid cyst or a lung abscess. She underwent lobectomy and postoperative histopathological study revealed IPT as the final diagnosis.ConclusionDue to the non-specific symptoms and rarity, IPT can be easily misdiagnosed at first. It is essential that physicians take into account the possibility of IPT when approaching a new case of lung mass.

INTRAPULMONARY TERATOMA: A CAUSE OF SHORTNESS OF BREATH IN A YOUNG WOMAN

SESSION TITLE: Tuesday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM INTRODUCTION: Intrapulmonary Teratoma (IPT) is a rare benign cystic lesion with fewer than 100 cases reported in medical literature(1). We report a case of an 18-year-old female with symptoms of shortness of breath, recurrent pulmonary effusions which, following thoracotomy, was attributed to a mature cystic teratoma containing respiratory and pancreatic tissue. CASE PRESENTATION: An 18-year-old female presented to the emergency room short of breath with right-sided chest pain. Notably, she had a month-long history of intermittent shortness of breath treated with antibiotics for presumed pneumonia only with marginal improvement in her symptoms. Initial vital signs and physical exam were unremarkable. Chest X-Ray showed a large right-sided pleural effusion, chest CT reported a large right-sided loculated pleural effusion with compressive atelectasis for which thoracentesis was done and a chest tube placed. She was given Ceftriaxone, Doxycycline along with tissue plasminogen activator (tPA) and dornase alpha (DNase), essentially managed as empyema. After clinical and radiographic improvement, she was discharged home on a 4-week course of Levofloxacin. 3 weeks from discharge, shortness of breath persisted with imaging notable for worsening right-sided pleural effusion(Figure 1). Subsequently, right thoracoscopy which was converted to right thoracotomy revealed a large complex multi-loculated cystic structure containing greenish material. Histology diagnosis was a mature cystic teratoma composed of respiratory and pancreatic tissue. Two-month follow up after removal of the teratoma in toto resulted in the patient having a complete clinical recovery. DISCUSSION: Since they were first described by Mohr, as few as 65 IPTs have been reported in literature between 1839 and 1996 (2).Patients age between 10 months and 68 years(3) with equal sex predilection and presenting complaints are often non-specific - chest pain (52%), hemoptysis (42%), cough (39%) and trichoptysis (13%), which is rare but pathognomonic. IPTs can appear as lobulated masses, cavitary lesions or as areas of consolidation on imaging. CT helps in estimating different elements that compose the teratoma (soft tissue/fluid/fat/calcification), differentiating ruptured from unruptured teratoma and, delineating degree of mediastinal invasion and/or proximity to vascular structures. Histopathologically, IPTs can demonstrate endo-, meso- or ectodermal elements like in our patient whose histology was impressive for respiratory epithelium and pancreatic tissue. There are reports of rupture of cysts containing pancreatic tissue owing to the production of proteolytic or digestive enzymes (2). For this reason and the possibility of being malignant, surgical excision is advised. CONCLUSIONS: IPTs are a rare entity and may present with non-specific symptoms. Radiographic imaging often assists in diagnosis and surgery is the mainstay of treatment. Reference #1: Ditah C, Templin T, Mandal R, Pinchot JW, Macke RA. Isolated intrapulmonary teratoma. J Thorac Cardiovasc Surg. 2016 Dec;152(6):e129–31. Reference #2: Asano S, Hoshikawa Y, Yamane Y, Ikeda M, Wakasa H. An intrapulmonary teratoma associated with bronchiectasia containing various kinds of primordium: a case report and review of the literature. Virchows Arch. 2000 Apr 10;436(4):384–8. Reference #3: Carter D, Eggleston JC. Teratoma. In: Hartmann WH, ed. Tumor of the Lower Respiratory Tract. Washington: Armed Forces Institute of Pathology, 1980: 325-6 DISCLOSURES: No relevant relationships by Rohit Aloor, source=Web Response no disclosure on file for Daniel Harley; No relevant relationships by ARJUN KANWAL, source=Web Response No relevant relationships by Vaishnavi Raman, source=Web Response No relevant relationships by Himanshu Rawal, source=Web Response

Large Mature Teratoma Presenting as Incidental Mediastinal Mass on Chest Radiograph

SESSION TITLE: Student/Resident Case Report Poster - Lung Pathology I SESSION TYPE: Student/Resident Case Report Poster PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM INTRODUCTION: Only 1-5% of all germ cell tumors (GCTs) are extra-gonadal. The mediastinum is the most common location for these tumors, and mature teratoma is the most common morphology of medistinal GCTs. CASE PRESENTATION: We present the case of an asymptomatic 26 year old female with a history of urticaria an allergic rhinitis who presented to her PCP for evaluation of a left hemithorax opacity incidentally diagnosed on CXR obtained during her green card application. Chest CT confirmed the presence of a loculated cystic left chest mass measuring 14 x 9 x 15 cm. The patient was initially referred to pulmonology, then to thoracic surgery after CT-guided aspiration that revealed benign histiocytes and lymphocytes. The patient underwent uncomplicated video-assisted thoracoscopy with resection of a multiloculated cystic structure filled with straw-colored serous fluid and yellow-gray grumous material without solid components that appeared to originate from the left lobe of the thymus. Pathology revealed a benign mature teratoma without neural elements. DISCUSSION: Mediastinal mature teratomas are rare, frequently asymptomatic, and discovered only incidentally as a result of their slow growth and the compliance of adjacent lung tissue. They may present with chest pain, dyspnea, cough, or less commonly hemoptysis or other complication of rupture. Historically trichoptysis has been described. Benign teratomas are most commonly cystic, whereas malignant teratomas are more commonly solid. Differential diagnosis includes malignant (immature) teratoma, and parasitic, fungal, or bacterial collections. After metastasis from a gonadal primary has been excluded, surgical excision is usually curative. CONCLUSIONS: The present case is a common presentation of a rare condition that highlights the importance of accurate diagnosis and expedient excision. Reference #1: Dasbaksi, Kallol, et al. “Intrapulmonary teratoma: Report of a case and review of literature.” Asian Cardiovascular and Thoracic Annals (2015): 0218492315583763. Reference #2: Drevelegas, Antonios, Panagiotis Palladas, and Anna Scordalaki. “Mediastinal germ cell tumors: a radiologic-pathologic review.” European radiology 11.10 (2001): 1925-1932. Reference #3: McKenney, Jesse K., Amy Heerema-McKenney, and Robert V. Rouse. “Extragonadal germ cell tumors: a review with emphasis on pathologic features, clinical prognostic variables, and differential diagnostic considerations.” Advances in anatomic pathology 14.2 (2007): 69-92. DISCLOSURE: The following authors have nothing to disclose: Sam Tirgari, Abraham Markin, Lester Kobylak No Product/Research Disclosure Information

Mature Teratoma Intrapulmonary in Adolescent

Mature teratoma is the most common primary germ cell tumor in the mediastinum, but very rare in the lung. A very rare case of mature giant intrapulmonary teratoma in a 14 year old female is reported. She had chronic cough, recurrent fever, chest pain, weight loss and history of breathless for six months. A chest x-ray showed a large mass with atelectasis of the left lung and thoracic CT scan revealed a giant neoplasm of the left lung, sized about 13x19 cm with calcification. The patient underwent left thoracotomy posterolateral, the tumor was totally resected with pneumonectomy. The histopatological examination revealed a mature teratoma. Intrapulmonary teratoma is very rare tumors with nonspecific signs and symptoms. Total removal tumor is the treatment of choice for this type of teratoma.

Paraparesis and pleural effusion in a young patient: A road less travelled

Intrapulmonary teratoma is a rare tumor of the lung, which is scarcely reported to have metastasis at presentation. Here, we report a case of a 14-year-old patient admitted with paraparesis and heaviness of the right side of the chest and was found to have compressive myelopathy along with pleural effusion. He had elevated alpha fetoprotein and beta human chorionic gonadotropin. Imaging revealed a heterogeneous, massive space lesion occupying the right hemithorax and collapse of D12 vertebra with altered marrow signal causing extradural spinal compression. Cytopathology from the tumor revealed immature teratoma cells. The patient was diagnosed as a case of intrapulmonary teratoma with vertebral metastasis. He was started on bleomycin, etoposide, cyclophosphamide chemotherapy and spinal irradiation, which was unsuccessful.

Mediastinal Teratoma With Coexisting Parenchymal Pulmonary Cystic Lesion

A double-located mediastinal and intrapulmonary cystic teratoma is a rare condition to be considered by thoracic surgeons. Clinical or radiologic diagnosis of a ruptured mediastinal teratoma into adjacent structures may be highly suggestive. An atypical presentation may indicate cautiousness for complete surgical excision. We report the case of a 14-year-old girl presenting with chronic chest pain. The radiologic work-up showed a large cystic mediastinal tumor and a heterogeneous intrapulmonary left upper-lobe lesion. We discuss the radiologic differential diagnosis of this atypical double-located thoracic tumor and the surgical strategy for complete excision.

Case report: Intrapulmonary teratoma (IPT) mimicking empyema: A missed diagnosis in primary care

Case report: Intrapulmonary teratoma (IPT) mimicking empyema: A missed diagnosis in primary care

Intrapulmonary Teratoma Presenting with Trichoptysis

Journal of Thoracic Oncology • Volume 8, Number 1, January 2013 A 60-year-old woman presented to our clinic with complaints of cough and expectoration for 1 week. The expectoration was persistent, non–foul smelling and often contained thin brown silky hairs (Fig. 1). She had otherwise been well and denied breathlessness, febrile sensation, and weight loss. Chest radiograph showed a right hilar mass and collapse of the right middle lobe. Computed tomography of the chest showed a fat-containing mass measuring 6.2 × 4.7 × 3.2 cm in the right Intrapulmonary Teratoma Presenting with Trichoptysis

Trichoptysis: a hairy presentation of a rare tumour

We describe the case of a 17-year-old hairdresser who presented with haemoptysis and trichoptysis due to benign intrapulmonary teratoma and her surgical management. The clinical and radiological features of this rare tumour are reviewed and the symptom of trichoptysis discussed.

Teratoma intrapulmonar maduro

Relato de caso de um homem de 49 anos com quadro de dor torácica e escarros hemópticos de início há seis meses. Pela radiografia e tomografia de tórax visualizou-se opacificação em lobo superior esquerdo. A broncoscopia mostrou restos hemáticos em segmento brônquico lingular. Frente à necessidade diagnóstica e terapêutica, optou-se por submetê-lo a uma toracotomia inframamilar à esquerda. O estudo anatomopatológico da peça cirúrgica revelou teratoma intrapulmonar. O paciente evoluiu satisfatoriamente e segue em acompanhamento ambulatorial.