Introduction to Mediastinal Teratoma

What is/are Mediastinal Teratoma?

Mediastinal Teratoma - The focus of this pictorial review will be to highlight the important distinguishing features of thymic hyperplasia, thymomas, thymic cysts, thymic neuroendocrine tumours (NETs), thymolipomas, mediastinal teratomas, and other mimics of thymic disease. ^[1] Background Mediastinal teratomas occasionally rupture into the thoracic cavity, which induces mediastinitis or various other severe complications. ^[2] BackgroundMediastinal teratomas are rare tumors that most frequently occur in the anterior mediastinum. ^[3] Type IV-only GCTs are either with mitotic CN-LOHs and abundant CNAs (seminoma, dysgerminoma, testicular mixed GCTs) or with scant CNAs and no CN-LOH (pediatric testicular and mediastinal teratomas). ^[4] Mediastinal teratoma rarely causes pericarditis. ^[5] A cystic mediastinal teratoma should be considered in the differential diagnosis of pericardial effusion. ^[6] Mediastinal teratomas account for <10% of all mediastinal masses. ^[7] The current report highlights the integrated work-up of an unexpected giant mediastinal teratoma in 28 years old female. ^[8] Computed tomography of the chest indicated the diagnosis of anterior mediastinal teratoma. ^[9] • Mediastinal teratoma is uncommon finding and most often present in young adults. ^[10] Trichoptysis (expectoration of hair) is a specific finding that may help distinguish this entity from mediastinal teratomas. ^[11] We report, a rare case of an anterior mediastinal teratoma occurring in early childhood. ^[12] The incidence of mediastinal teratomas is low, it’s important to recognize them between all the differential diagnoses for mediastinal tumors. ^[13] Highlights • Ruptured mediastinal teratomas (RMTs) may lead to mediastinitis. ^[14] The fetal outcome in the case of mediastinal teratoma relies on the development of hydrops due to mass compression of vessels and heart failure. ^[15] Mediastinal teratoma (MT) can be misdiagnosed for a long period and revealed by fatal pleural effusion at any age. ^[16] Congenital mediastinal teratoma can lead to development of hydrops fetalis and may be misinterpreted on ultrasound. ^[17] Primary mediastinal teratoma is relatively rare, and removal of giant mediastinal teratoma by thoracoscopic surgery has rarely been reported. ^[18] CT imaging showed a heterogeneous enhancement mass in the middle mediastinum with cyst and calcification, suggesting the diagnosis of mediastinal teratoma. ^[19] Mediastinal teratoma is an uncommon finding in the pediatric age group, accounting for only 7–11% of extragonadal teratomas. ^[20] Nine nonpulmonary arterial hypertension controls included as follows: mild/moderate left ventricular outflow tract obstruction (7), mediastinal teratoma (1), portal vein stenosis (1). ^[21] The robotic-assisted right thoracoscopic approach allowed for a minimally invasive dissection with good visualization and minimal morbidity when compared to previous cases of surgically resected mediastinal teratomas. ^[22] Surgical resection remains the treatment of choice for mature mediastinal teratoma, and the operation itself is sometimes complicated or life‐threatening, especially when it ruptures into adjacent vital structures. ^[23] We report a case of an adult man who underwent surgical resection of a presumed anterior mediastinal teratoma, which upon histopathologic assessment was diagnosed as an epithelioid hemangioendothelioma (EHE). ^[24] Mediastinal teratomas are typically benign extragonadal germ cell tumors derived from all three embryonic cell layers (ectoderm, mesoderm, and endoderm). ^[25] The frequency of mediastinal teratomas ranged from 1 to 5 %, in most cases with localization in the anterior/superior mediastinum. ^[26]

Anterior Mediastinal Teratoma

Computed tomography of the chest indicated the diagnosis of anterior mediastinal teratoma. ^[1] We report, a rare case of an anterior mediastinal teratoma occurring in early childhood. ^[2] We report a case of an adult man who underwent surgical resection of a presumed anterior mediastinal teratoma, which upon histopathologic assessment was diagnosed as an epithelioid hemangioendothelioma (EHE). ^[3]