Adenocarcinoma arising in anterior mediastinal mature cystic teratoma: Report of a case

Abstract

Mediastinal mature teratoma with malignant components is a very rare condition. A 57-year-old man presented with a large (14 x 10 cm) encapsulated and lobulated cystic mass involving the anterior mediastinum. The most consistent diagnosis on the basis of radiological findings was mature cystic teratoma, and a surgical resection was thus indicated. The operation was performed through a median sternotomy, and the tumor was extirpated with a combined resection of the pericardium and left mediastinal pleura. Although the pathological diagnosis was mature cystic teratoma, this patient showed a recurrence of malignant effusion 7 months following the operation. The earlier resected specimen was pathologically re-reviewed according to the blocked entire mass, and small foci of adenocarcinoma were thus found within the tumor.

Mediastinal Teratoma with Coexisting Adenocarcinoma and Carcinoid Tumor (Somatic-Type Malignancy): A Case Report with a Review of the Literature

“…A minimum size of one low-power field has been suggested as the threshold for the diagnosis of somatic-type malignancy in germ cell tumors [1,2]. The majority of reports of somatictype malignancy in teratomas has described a single histological type of malignancy [4,7]. However, Armah et al [8] described a renal teratoma similar to our case, where coexisting adenocarcinoma and carcinoid tumor were seen.…”

“…It accounts for 5%-10% of all mediastinal tumors [1]. The coexistence of a malignant component in mature teratoma is extremely rare [1,4,6]. Non-germ cell malignancies arising in a teratoma have been described as teratoma with malignant transformation [1,2,4].…”

“…Mature teratoma is a primary germ cell neoplasm that consists of fully differentiated adult tissues derived from more than one of the three embryonic germ cell layers: ectoderm, mesoderm, and endoderm [1,3,4]. It accounts for 5%-10% of all mediastinal tumors [1].…”

“…According to most recent World Health Organization (WHO) classification, this is described as teratoma with somatic-type malignancies [1,2]. These lesions, especially in the mediastinum, are very rare, with only a few documented cases [3,4]. The malignancies reported in mature mediastinal teratomas include sarcoma, adenocarcinoma, squamous cell carcinoma, and neuroendocrine neoplasms [2].…”

Unilateral vocal cord palsy as the presentation of metastatic mediastinal adenocarcinoma

“…Only one case was from primary mediastinal tumour and mediastinal lymphoma respectively 5 . Primary adenocarcinoma of mediastinum is very rare although it has been sporadically reported for example a originating from a calcified nodule or mature teratoma 6,7 . More commonly, the lesion is a secondary metastasis from lung, gastrointestinal tract, pancreas, kidney or even the pituitary gland 3 .…”