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Weekly Chest CasesArchive of Old Cases

Case No : 959 Date 2016-03-14

  • Courtesy of Kun Young Lim, MD, Hyae Young Kim, MD, Soo Hyun Lee, MD / National Cancer Center, Korea
  • Age/Sex 31 / F
  • Chief ComplaintCough
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Mature cystic teratoma
Radiologic Findings
Fig. 1 Radiograph shows a large, well-defined mediastinal mass and pleural effusion in right hemithorax.

Fig. 2, 3 CT scans show a multiseptated cystic mass with fat density that extends to middle and posterior mediastinal compartments.

Fig. 4 PET-CT scan reveals a cystic mass with uneven minimal hypermetabolism along the septae.

Mediastinal mass excision was done and pathology confirmed mature cystic teratoma
Brief Review
Mature cystic teratoma is the most common germ cell neoplasm. It occurs more frequently in young adults. Majority are located in the anterior mediastinum, with only 3%–8% occurring in the posterior mediastinum. On CT it present as heterogeneous, well-defined masses with enhancing walls and septae. It may contain soft tissue, fluid, fat, and calcium, but in a small percentage of cases teratoma may be present as a cystic lesion that contain neither fat nor calcification.
Most cystic teratomas are multilocular, but unilocular cystic lesions also occur. Calcifications may be focal, rim like, or, representative of teeth or bone. A fat-fluid level within the mass is a specific finding; however it is rarely seen.
Please refer to
Case 150, Case 175, Case 443,
References
1. Jeung MY, Gasser B, Gangi A, Bogorin A, Charneau D, Wihlm JM, et al. Imaging of cystic masses of the mediastinum. Radiographics 2002; 22:S79-S93.
Keywords
Mediastinum, Benign tumor,

No. of Applicants : 110

▶ Correct Answer : 36/110,  32.7%
  • - Juntendo University Hospital , Japan Akifumi Hagiwara
  • - Nihon University Itabashi Hospital , Japan Yusuke Watanabe
  • - Policlinico Umberto I , Italy Paolo Baldassari
  • - Kyungpook national university hospital, Korea , Korea (South) SUNGJUN MOON
  • - Myongji hospital , Korea (South) Ji Ye Lee
  • - Korea University Guro Hospital , Korea (South) Hwanseok Yong
  • - Korea University Guro Hospital , Korea (South) Jeong Woo Kim
  • - Saitama-Sekishinkai Hosptal , Japan Mihoko Yamazaki
  • - chosun university hospital , Korea (South) Eunju Yoon
  • - , Korea (South) BAEK YOOLIM
  • - Ajou University Hospital , Korea (South) Seulgi You
  • - Seirei Hamamatsu General Hospital , Japan Kenichi Mizuki
  • - University of ottawa , Canada Subramaniyah Ramanathan
  • - Kyungpook national university , Korea (South) Chungeun Lim
  • - University of Tsukuba, Dept of Radiologt , Japan Manabu Minami
  • - Asan Medical Center , Korea (South) Hyung Jung Koo
  • - The Jikei university , Japan Taku Gomi
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Centre Hospitalier Boulogne-sur-Mer , France Benjamin Damarey
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - Kishiwada City Hospital , Japan Hiroshi Tagawa
  • - Shinmatsudo Central General Hospital , Japan Taku Tajima
  • - Private sector , Greece Vasilios Tzilas
  • - Pusan national university hospital , Korea (South) So Park
  • - Ajou University Hospital , Korea (South) Young Keun Sur
  • - Pusan national university hospital , Korea (South) MIRI JEONG
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Han Na Lee
  • - chp st martin , France Mariotte benoit
  • - Niigata University , Japan Atsushi Uehara
  • - National Center hospital of Neurology and Psychiatry , Japan Kaoru Sumida
  • - Pusan national university hospital , Korea (South) Minkyu Kwak
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - Pusan national university hospital , Korea (South) SeungHyun Lee
  • - Ajou university hospital , Korea (South) DONGHYUN LEE
▶ Correct Answer as Differential Diagnosis : 22/110,  20.0%
  • - Chonnam National University Hospital , Korea (South) So yeon Ki
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - Eren Hastanesi Istanbul , Turkey Armagan Sarac
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Pusan national university hospital , Korea (South) hie bum suh
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - the first affiliatited hospital of nanjing medical univercity , China Hai Xu
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Human medical imaging % intervention center , Korea (South) Suryoung Jun
  • - IRSA LA ROCHELLE , France, Metropolitan BIGOT
  • - Les cedres St malo , France nicolas gautier
  • - Kinki University Faculty of Medicine, , Japan Mitsuru Matsuki
  • - pusan national university hospital , Korea (South) kim jeongmyeong
  • - Pusan National University Hospital , Korea (South) Jeong Bin Park
  • - PNUH , Korea (South) Seungbaek Hong
  • - Pusan national university hospital , Korea (South) Jin Joo Kim
  • - Busan national univercity hospital radiology department , Korea (South) Il-wan Son
  • - DAYA General Hospital,Thrissur,Kerala , India Raveendran TK
  • - Medicheck health care , Korea (South) Chae Lim
  • - Himeji Red Cross Hospital , Japan Mayu Uka
▶ Semi-Correct Answer : 1/110,  0.9%
  • - Chungbuk national university , Korea (South) Yong Kim
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