Archive of Old Cases
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Case No : 315 Date 2003-11-08
- Courtesy of Yoo Mi Chang, M.D., Kyung-Hyun Do, M.D., Jae-Woo Song, M.D., Jin Seong Lee, M.D. / Asan Medical Center, Seoul Korea
- Age/Sex 29 / M
- Chief ComplaintChest pain (onset: 10 days). Previously heathy
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Ruptured teratoma
- Radiologic Findings
- Chest PA shows ill defined mass-like consolidation in right lower lung zone. bilateral pleural effusion is seen. Chest CT scan shows heterogeneous attenuated mass adjacent to cardiac border. Moderate amount of pleural effusion and passive atelectasis is seen in right hemithorax.
On another image, The mass has a portion of low density lesion representing fatty component.
Mass excision was done. the mass was attached to adjacent tissue. The outer surface of the mass is pinkish red, smooth and glistening. The cut surface shows a greasy yellow materials and polypoid whitish yellow lesion. No solid mass is present. - Brief Review
- Ruptured teratoma
Rarely, rupture into adjacent structures
: pleural space, pericardium, lung or tracheobronchial tree
Produce proteolytic or digestive enzymes, leading to adhesion and erosion of surrounding structures
17 cases of surgically resected mediastinal teratomas
-Severe symptoms (chest pain or hemoptysis) -71%
-CT findings
1) Internal architecture: homogeneity to heterogeneity 90%
2) Tumor margin: smooth to irregular
3) Fat component: spherical to a bursting configuration
4) Bronchial invasion and adjacent lung consolidation in 3 patients
5) Pericardial effusion in 1 patient and pleural effusion in 4 patients - References
- Mediastinal teratoma: CT differentiation of ruptured and unruptured tumors. Choi SJ, Lee JS, song KS, Lim TH. AJR 1998: 171;591-594
- Keywords
- Mediastinum, Benign tumor,
No. of Applicants : 18
- ▶ Correct Answer : 8/18, 44.4%
-
- - Asan Medical Center, Korea Eun Jin Chae
- - CHU Nancy-Brabois, France Denis Regent
- - Chungju Saeroun hospital, Korea Cheolkyu Jung
- - Ewha Women's University Hospital, Korea Sung Shine Shim
- - Homs National Hospital, Homs, Syria Rami Abou Zalaf
- - Kyunghee University Hospital, Korea Kyung Ran Ko
- - Mallinckrodt Institute of Radiology, USA Jin Mo Goo
- - Seoul National University Hospital, Korea Jung-Gi Im
- ▶ Semi-Correct Answer : 3/18, 16.7%
-
- - Centre d'imagerie Jacques Callot, Nancy, France Centre d'imagerie Jacques Callot, Nancy, France
- - Geoje Baek Hospital , Gyungnam, Korea Geoje Baek Hospital , Gyungnam, Korea
- - Incheon Sarang Hospital, Korea Incheon Sarang Hospital, Korea
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