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

Abstract

Background Intrapulmonary 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 presentation We 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. Conclusion Due 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.

A Case Report of Intrapulmonary Mature Cystic Teratoma of the Lung

“…Other symptoms reported in the literature include trichophytic, pneumonia, fever, bronchiectasis, abscesses, and infection (8). The size of the neoplasm is not related to malignancy (7,8). Reports of various studies have shown that laboratory tests are generally unremarkable (9,10), which is concordant with our case.…”

“…Studies have shown that a lobulated cystic lesion with peripheral translucency is distinctive for the diagnosis of teratoma on CT, as in our case, though having such specific features as peripheral calcification or translucency; our clinicians missed the differential diagnosis of teratoma, which is due to the lack of information and rarity of the lesion. The commonly mentioned preoperative differential diagnoses are lung abscess and hydatid cyst (8). In our case, the preoperative chest X-ray and CT scan resulted in the misdiagnosis of a lung abscess, after which the patient was treated with a broad-spectrum antibiotic.…”

“…In this case, the patient complained of dry cough and hemoptysis, the most commonly reported symptoms. Other symptoms reported in the literature include trichophytic, pneumonia, fever, bronchiectasis, abscesses, and infection (8). The size of the neoplasm is not related to malignancy (7,8).…”

Mediastinal Mature Cystic Teratoma With Intrapulmonary Extension Mimicking a Hydatid Cyst: Advantages of MRI in Diagnostics

“…Nonetheless, the results may occasionally demonstrate non-specific findings. In cases where malignancy is suspected, further studies, such as an MRI of the chest or PET-CT, may be required to establish a definitive diagnosis [ 5 , 6 , 8 ].…”

“…Pulmonary hydatid cysts typically affect the lower lobes, with a preference for the right basal lobe. Cystic teratomas and hydatid cysts may mimic each other and distinguishing between the two requires careful interpretation of the patient’s clinical context, serological data, and radiographic imaging, with CT and MRI being the most useful modalities for detecting pulmonary cysts and their complications [ 4 , 8 , 12 ]. In our case, MRI was the most accurate imaging modality, showing elements of fat and other characteristics of cystic teratoma, such as intraparenchymal infiltration and direct bronchial connection, which is a distinguishing feature of intrapulmonary teratoma.…”