BACKGROUND: Teratomas are the most common of germ cell tumor and have different epidemiology, histology, and biology than the others. These tumors occur equally in men and women are generally benign, occur in the mediastinum and compromise approximately 20% of anterior mediastinal masses. All forms of these tumors have a peak incidence in young adults. CASE REPORT: A huge mediastinal teratoma present in young girl 15 years old, a tumor located in the right chest with mass compression effect to spine, heart, and lung, produce prolong symptoms of dyspnea and chest pain. Delayed clinical presentation influences to post-operative complications such as prolong atelectasis, rupture of tumor mass which spoiled of tumor contents, empyema, and sepsis. CONCLUSION: Mediastinal mature teratoma with the delayed clinical presentation will give technical difficulties for resection and increase the risk of post-operative complications.

Both retinoblastoma and neuroblastoma are common childhood malignancy, which classified as malignant round cell tumors, but have different diagnostic, therapeutic, prognostic criteria and metastases pattern. A case was evaluated with an imaging examination resembled neuroblastoma metastatic process but was diagnosed as retinoblastoma. A 2-years-old boy came with chief complaint swollen right eye. Prior history was itchy and increasingly swollen right eye, decreased vision and gradually increases pain. There was no sign of leukocoria. Histopathology result confirmed malignant round cell tumor. Axial contrast-enhanced head CT image, depicted right intra orbital mass, 1.9x2x1.8 cm in size as well as mass in the right frontoparietal region which pushed the right frontal lobe, accompanied by erosion and periosteal reaction in the surrounding bone with meningeal and soft tissue involvement. In this case, although there was no leukocoria as the diagnostic criteria for retinoblastoma, we still found intraorbital and pineal body mass also malignancies in several long bones. The diagnosis of trilateral retinoblastoma has been established followed by retinoblastoma’s chemotherapy regiment, which showed good response, in spite of discrepancy in retinoblastoma’s metastases pattern. A complete systemic workup includes CT scan examination needs to be perform in order to help the clinicians determine the diagnosis of orbital mass with malignant round cell histopathology.