Benign Mediastinal Teratoma with Intrapulmonary and Bronchial Rupture Presenting with Recurrent Hemoptysis

Abstract

Mediastinal teratomas are usually asymptomatic tumors, located most commonly in the anterior mediastinum. Very rarely, such tumors may rupture into the tracheobronchial tree, lung, pleura or pericardium. Computed Tomography (CT) is helpful in the diagnosis and differentiation of ruptured and unruptured tumors.We report a case of ruptured anterior mediastinal teratoma in a 20-year-old female presenting with recurrent hemoptysis and cough; thus, mimicking a lung malignancy or tuberculosis. CT demonstrated a heterogeneous fat containing lesion in the anterior mediastinum with extension into the lingular lobe. Subsequent fine needle aspiration cytology (FNAC) yielded plenty of anucleate squames and debris, and a clear cut diagnosis could not be made. Total excision of the tumor was performed and histopathology of the surgically excised mass confirmed the CT diagnosis.

Ruptured anterior mediastinal teratoma with radiologic, pathologic, and bronchoscopic correlation

“…While several cases of ruptured teratoma have been presented in the literature, we add to the literature a distinctive case of this rare entity with radiologic, pathologic, and bronchoscopic correlation [2][3][4][5][6][7][8].…”

Cystic Lesions of Anterior Mediastinum: Case Report

“…Benign lesions have no sex predilection; however, malignant ones are more common in males. Mediastinal teratomas rarely produce symptoms except when they attain large size or may rupture into the lung and bronchial tree, pleural space, pericardial space, or great vessels which can lead to the life threathinig complications (11,12,13).…”

Mediastinal teratoma presenting with hemoptysis and pleuritis misdiagnosed as tuberculosis (empyema)

“…Mediastinal teratoma with pulmonary and pleural involvement is rare, but the most common symptoms are dyspnea, continuous cough and chest pain [ 7 , 8 ]. Hemoptysis is a very rare symptom of mediastinal teratoma, and is usually caused by recurrent infection due to lung compression or tumor rupture into the lung [ 3 – 5 ]. In each of these cases, the teratoma had invaded adjacent tissue, especially the lung.…”

“…In a few cases, calcification and cavitation are found in teratomas accompanied by lung erosion, resulting in a misdiagnosis of tuberculosis [ 3 , 8 ], especially in developing countries with a high tuberculosis burden such as China. A case of mediastinal teratoma misdiagnosed as empyema in the early stages has also been reported before, and pleural effusion appeared to be purulent [ 9 ].…”