Massive Mature Mediastinal Teratoma With Malignant Transformation: An Unusual Case Report

Authors

  • Karla Kalua Department of Radiology General Hospital Dr. Moewardi/ Faculty of Medicine Universitas Sebelas Maret http://orcid.org/0000-0002-3729-3594
  • Widiastuti Soewondo Department of Radiology General Hospital Dr. Moewardi/ Faculty of Medicine Universitas Sebelas Maret

DOI:

https://doi.org/10.26911/theijmed.2024.09.02.07

Abstract

Background: Teratoma is a type of germ cell tumor that is rarely found in the anterior mediastinum. Meanwhile, mature mediastinal teratoma with malignant transformation is rare and develops rapidly, with a poor prognosis. This article aims to report one of the uncommon cases of mature teratoma and discuss its imaging features thereby adding insight in providing an accurate diagnosis of this condition.


Case Report: This study presents a case of a 26-year-old male patient who has complained of shortness of breath for 3 months and worsening in the last 3 days. The patient passed through a chest radiographic examination and was diagnosed with a mediastinal tumor. The contrast-enhanced chest computed tomography showed a huge mediastinal mass occupying the right and left hemithorax, measuring 16.9 cm x 20.5 cm x 20.9 cm and pressing against the chest wall, esophagus, trachea, great vessels, and the vital organs, lungs as well as heart, causing several complications in patients.


Conclusion: Knowledge of the teratoma radiological appearance and the characteristics of the various subtypes is very important in the diagnosis of mediastinal teratoma diagnosis for immediate and appropriate treatment.

References

Agarwal S, Mullick S, Gupta K, Dewan RK, (2015). Mediastinal teratoma with coexisting adenocarcinoma and carcinoid tumor (somatictype malignancy): a case report with a review of the literature. Turk Thorac J 16, 101–104. DOI:10.5152/ttd.2014.4280

Anushree CN (2015). Mature mediastinal teratoma. JCDR. DOI:10.7860/JCDR/2015/11902.6088

Carter BW, Okumura M, Detterbeck FC, Marom EM, 2014. Approaching the Patient with an Anterior Mediastinal Mass: A Guide for Radiologists. Journal of Thoracic Oncology 9, S110–S118. DOI: 10.1097/JTO.0000000000000295

Chow M, Lim T (2014). Massive mediastinal teratoma mimicking pleural effusion on computed tomography. smedj 55, e67–e68. DOI:10.11622/smedj.2013211

Foladi N, Farzam F, Rahil N, Hoshang MMS, (2020). CT features of mature teratoma in the mediastinum of two young adults—a report of two cases. Egypt J Radiol Nucl Med 51, 234. DOI:10.1186/s43055020003606

Kim SG, Jeong WG, Song SY, Lee T, Lee JE, Park HM, Kim YH (2022). Mediastinal Teratoma: A Pictorial Essay. J Korean Soc Radiol. 8: 597. DOI:10.3348/jksr.2021.0186

Le Fèvre C, Vigneron C, Schuster H, Walter A, Marcellin L, Massard G, Lutz P, Noël G (2018). Metastatic mediastinal mature teratoma with malignant transformation in a young man with an adenocarcinoma in a Klinefelter’s syndrome: Case report and review of the literature. Cancer/Radiothérapie 22, 255–263. DOI:10.1016/j.canrad.2017.10.006

Lee H, Seon HJ, Choi Y (2018). Radiological‐pathological correlation of malignant teratoma with liposarcomatous transformation: P roven by repeated transthoracic needle biopsy. Thoracic Cancer 9, 185–188. DOI:10.1111/17597714.12553

Nakazono T, Yamaguchi K, Egashira R, Mizuguchi M, Irie H (2021). Anterior mediastinal lesions: CT and MRI features and differential diagnosis. Jpn J Radiol 39, 101–117. DOI:10.1007/s11604020010312

Rosti G, Secondino S, Necchi A, Fornarini G, Pedrazzoli P (2019). Primary mediastinal germ cell tumors. Seminars in Oncology 46, 107–111. DOI:10.1053/j.seminoncol.2019.04.001

Tomiyama N, Honda O, Tsubamoto M, Inoue A, Sumikawa H, Kuriyama K, Kusumoto M, Johkoh T, Nakamura H (2009). Anterior mediastinal tumors: Diagnostic accuracy of CT and MRI. European Journal of Radiology 69, 280–288. DOI:10.1016/j.ejrad.2007.10.002

Tu L, Sun L, Zhou Y, Gong Y, Xue J, Gao J, Lu Y, Wang Y (2013). Postoperative radiotherapy for residual tumor of primary mediastinal carcinoid teratoma. J Thorac Dis. 5:E6164. DOI:10.3978/j.issn.20721439.2012.11.11

Wang J, Kazmi SAJ (2011). Teratoma with Malignant Transformation: A Case Report with Pathological, Cytogenetic, and Immunohistochemistry Analysis. Sarcoma. 2011:1–5. DOI:10.1155/2011/450743

Wang R, Li H, Jiang J, Xu G (2020). Incidence, treatment, and survival analysis in mediastinal malignant teratoma population. Transl Cancer Res TCR 9, 2492–2502. DOI:10.21037/tcr.2020.03.19

Downloads

Published

2024-06-06