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Weekly Chest CasesArchive of Old Cases

Case No : 588 Date 2009-02-02

  • Courtesy of Lee Ki Yeol, MD. / Korea University Ansan Hospital, Korea.
  • Age/Sex 3 / M
  • Chief ComplaintCough & dyspnea for 1 day
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Mature Teratoma
Radiologic Findings
Unenhanced CT shows well demarcated, elongated soft tissue mass at the left lateral border of the vertebral bodies between T9 and T10. After CE, this mass is minimally enhanced. We differentiated neurogenic tumor, neurenteric cyst, and extralobar pulmonary sequestration. Specimen photograph (A) of this mass shows cartilaginous portion (arrows in Fig.A, Fig.B). A thin adipose tissue was seen at the low power field (arrowheads in Fig.C).
Brief Review
Most mediastinal mature teratomas arise in the anterior mediastinum. 3% were in the posterior mediastinum. Mediastinal mature teratomas manifest as unilateral, sharply marginated, lobulated, heterogenous masses.
The findings at CT are variable. Water density in the cystic component is common, and fat density is seen in one fourth to one half of the patients. A fat-fluid level may be seen, or fat and fluid may be more immediately mixed. A definite cyst wall, which may show curvilinear calcification, is often visible. The combination of a large anterior mediastinal mass, which is wholly or predominantly composed of a cyst, with a well-defined wall is highly suggestive of a cystic teratoma. With calcification in the wall of the cyst or small spherical or irregular calcifications within the mass, cystic teratoma is even more likely. Unequivocal fat within the mass, particularly a fat-fluid level, makes this diagnosis certain.
References
1. Moeller KH, Rosado-de-Christenson ML, Templeton PA. Mediastinal mature teratoma: imaging features. AJR 1997;169:985-990
2. Amstrong P. Mediastinal and Hilar Disorders. In: Amstrong P, Wilson AG, Dee P, Hansell DM eds. Imaging of diseases of the chest.
Keywords
Mediastinum, Paravertebral, Benign tumor,

No. of Applicants : 86

▶ Correct Answer as Differential Diagnosis : 2/86,  2.3%
  • - Armed Forces Chun-Cheon Hospital , Korea (South) Chaehun Lim
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
▶ Semi-Correct Answer : 76/86,  88.4%
  • - Shiga University of Medical Science , Japan Norihisa Nitta
  • - Chungnam National University hospital , Korea (South) Kyoung Jin Oh
  • - The Armed Forces HamPyeong Hospital , Korea (South) Bae Geun Oh
  • - Samsung Medical Center , Korea (South) Dae Kun Oh
  • - Father Muller Medical College , Mangalore , India nabil mahmood
  • - Cairo University , Egypt Mamdouh Eissa
  • - Shinchon Severance Hospital , Korea (South) Ho-Joon Lee
  • - PingTung Christian Hospital ,China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - CHRU Lille , France Benjamin Damarey
  • - KONARK DIAGNOSTIC CENTRE , India AHAMAD MUKARRAB
  • - Univ. of Miami/Jackson Memorial , United States mantosh rattan
  • - Soonchunhyang university Bucheon hospital , Korea (South) Minhee Lee
  • - Chung-Ang University Medical center , Korea (South) Changkeun Sung
  • - Osaka University , Japan Osamu Honda
  • - Samsung Medical Center , Korea (South) Eun Kim
  • - hospital Sao Paulo , Brazil israel missrie
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Lilavati Hospital & Research Centre , India Mahavir Swami
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Dana Farber cancer Institute , United States jyothi jagannathan
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Mediacl IT Consulting , Japan Kazumasa Nishimura
  • - CH Sud Rnion , Reunion jean-baptiste Noel
  • - Ruby Hall Clinic , India sudarshan rawat
  • - chp st martin , France Mariotte benoit
  • - Seoul National University Hospital , Korea (South) Kwang Nam Jin
  • - Yashoda Super Speciality hospital , India Ramesh Pandey
  • - john h stroger hsp , United States dheeraj reddy gopireddy
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - KMC,Manipal , India satish maddukuri
  • - SNUH , Korea (South) Youkyung Lee
  • - McGill University Health Centre , Canada Amr Ajlan
  • - UCLA , United States Fereidoun Abtin
  • - Trakya Univercity School of Medicine , Turkey Armagan Sarac
  • - Trakya University School of Medicine, TKE, , Turkey GAR KUTLUTK
  • - Changhua Christian Hospital , Taiwan Chia-Fu Tsai
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Saga University , Japan Ryoko Egashira
  • - seoul national university hospital , Korea (South) Ijin Joo
  • - Soonchunhyang University Cheonan Hospital , Korea (South) Park Sang Hyun
  • - National Taiwan University Hospital , Taiwan Chin-Chung Shu
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Asian Heart Institute, Nirman Hitech & Apollo clinic , India Jeshil Shah
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - second hospital xian jiaotong university , China li ming
  • - IRSA , France jean -luc BIGOT
  • - SMC , Korea (South) Jihoon Cha
  • - DCA, , India Rajesh Gothi
  • - HOSPITAL SOTIRIA , Greece AIKATERINI DELAVERI
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - Asan Medical Center , Korea (South) Jae-Woo Song
  • - apollo hospitals , India harish bhambore
  • - CHRU lille , France manuel toledano
  • - CHR ANNECY , France Olivier Segall
  • - Hopital universitaire Lausanne , Switzerland abed kourhani
  • - Radiology , Korea (South) Jaewon Kim
  • - kims,narkatpally , India k bhaskar
  • - MD Nanavati Hospital,Mumbai, INDIA , India Sushant Bhadane
  • - ASL BOLOGNA - MAGGIORE HOSPITAL- ITALY , Italy MARCELLINO BURZI
  • - NASA SCANS , India RAKESH BHATIA
  • - CHU Grenoble , France Fabrice Bing
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - Homs National Hospital , Syria Rami Abou Zalaf
  • - NOUR EL-ISLAM RADIOLOGY CENTER , Egypt elsayed mousa
  • - Doctors Hospital , Bahamas muneesh sharma
  • - Hanmaeum Hospital , Korea (South) Kwon Hyoung Kim
  • - Vital Imaging Centre, Mumbai,India , India Ganesh Agrawal
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - UZ GASTHUISBERG , Belgium Johan COOLEN
  • - Beaulieu clinic Geneva , Switzerland gilles GENIN
  • - ROHINI Scans. Ambattur, Chennai , India Umapathi Mahesh
  • - PITTWATER RADIOLOGY , Australia Saurabh Khandelwal
  • - PITTWATER RADIOLOGY , Australia Julie Arora
  • - Trakya University School of Medicine , Turkey Umut Ugur
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
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