Median sternotomy enabled complete resection of a giant mature mediastinal teratoma in a 17-year-old male, with no recurrence and full symptom resolution at 12 months.
Case Report (n=1)
No
Large cyst-dominant mediastinal teratomas can closely mimic pericardial cysts on CT, highlighting the value of multimodality imaging (like TEE) and early surgical resection for accurate diagnosis and cure.
Mature mediastinal teratomas are uncommon benign germ cell tumors. When the cystic component predominates and typical features such as fat or calcification are absent, diagnosis can be misleading. A 17-year-old male had a brief syncopal episode two months prior. At presentation, his primary complaint was mild chest tightness. Chest computed tomography showed a 13.6 × 10.3 × 7.9 cm homogeneous cystic mass in the anterior mediastinum, closely attached to the pericardium. Attenuation measured 17 ± 15 Hounsfield units on non-contrast computed tomography, consistent with fluid density and showing no enhancement. Transesophageal echocardiography confirmed that the lesion compressed but did not invade the heart, indicating an extrapericardial mass. It was initially diagnosed as a pericardial cyst. Because of its large size and dense pericardial attachment, the tumor was resected via median sternotomy. Histology demonstrated mature cystic teratoma. Recovery was uneventful. Cyst-dominant teratoma can closely resemble a pericardial cyst on computed tomography. Using complementary imaging such as transesophageal echocardiography or magnetic resonance imaging helps avoid misinterpretation. Early complete removal ensures accurate diagnosis and excellent prognosis.
Liang et al. (Wed,) conducted a case report in Adolescent male (17 years) with a giant (13.6 × 10.3 × 7.9 cm) mature cystic mediastinal teratoma mimicking a pericardial cyst (n=1). Surgical resection via median sternotomy vs. Initial diagnostic observation or non-surgical management was considered but surgery was chosen due to size and symptoms was evaluated on Recurrence-free survival and symptom resolution at 12 months post complete resection of mature cystic teratoma. Median sternotomy enabled complete resection of a giant mature mediastinal teratoma in a 17-year-old male, with no recurrence and full symptom resolution at 12 months.