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Weekly Chest CasesArchive of Old Cases

Case No : 971 Date 2016-06-06

  • Courtesy of Mi Jung Park, Kyung Nyeo Jeon* / Gyeongsang National University Hospital, Changwon Gyeongsang National University Hospital*
  • Age/Sex 21 / M
  • Chief Complaintincidentally detected abnormality on routine check up
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Mature cystic teratoma
Radiologic Findings
Chest radiograph shows well-defined bulge iing mass in left side cardiac contour. Chest precontrast CT shows well circumscribed heterogeneous density well-defined cystic mass, with smalsmall amount ofl fat content and amorphous calcification, located in anterior mediastinum, abutting left atrial appendage. Chest pPostcontrast CT shows no enhancement in the mass, suggesting cystic nature.
Brief Review
Mature cystic teratomas (dermoid cysts) are cystic tumors composed of well-differentiated derivations from at least two of the three germ cell layers (ectoderm, mesoderm, and endoderm). Mature cystic teratomas are the most common germ cell neoplasm. They occur more frequently in young adults. Most are asymptomatic and are incidentally discovered, but large tumors may cause chest pain, dyspnea, cough, or other symptoms of compression. The majority of dermoid cysts are in the anterior mediastinum, with only 3%–8% occurring in the posterior mediastinum.
At On radiography, cystic teratomas usually appear as a sharply marginated, rounded or lobulated anterior mediastinal mass that extends to one side of the midline. Calcification, ossification, or even teeth may be visible on chest radiographs. At On CT, these tumors are heterogeneous, well-defined masses with walls of variable thickness that may enhance. They may contain all four tissue types, including soft tissue, fluid, fat, and calcium, but fluid-containing cystic components are usually prominent. Calcifications may be focal, rim-like, or, in rare cases, representative of teeth or bone. A fat-fluid level within the mass is a highly specific finding but is seen less frequently.
References
Radiographics;2002;22;579 Imaging of Cystic Masses of the Mediastinum
Keywords
Mediastinum, Benign tumor,

No. of Applicants : 94

▶ Correct Answer : 21/94,  22.3%
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - Samsung Medical Center , Korea (South) Boda Nam
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Pamukkale University, Faculty of Medicine, Dept. of Radiology , Turkey Furkan Ufuk
  • - The first affiliated Hospital of Xiamen University , China Qing Qiang Guo
  • - university of montreal , Canada Andrei Gorgos I
  • - Ajou university hospital , Korea (South) DONGHYUN LEE
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - CHRU Lille , France Paul Lebert
  • - Kashan University of Medical Sciences, kashan , Iran Ebrahim Razi
  • - Chonnam National University Hospital , Korea (South) So Yeon Ki
  • - SNUH , Korea (South) Juil Park
  • - Pusan national university hospital , Korea (South) hie bum suh
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Chungbuk national university hospital , Korea (South) Miran Yeon
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - The University of Tokyo Hospital , Japan Kaoru Sumida
  • - Department of Radiology, Seoul National University Bundang Hospital , Korea (South) Sung Hyun Yoon
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Nasaret Hospital , Korea (South) Hee Seok Choi
▶ Correct Answer as Differential Diagnosis : 29/94,  30.9%
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - yanbian university , China yin bo
  • - Pusan national university hospital , Korea (South) Jin Joo Kim
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - dayanand , India reena gupta
  • - ICD,MCH CALICUT , India rikhy krishnan
  • - GHICL , France manuel toledano
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - The University of Tokyo Hospital , Japan Yusuke Watanabe
  • - Seoul national university hospital , Korea (South) Kumju Chae
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - Dankook university hospital , Korea (South) Dabi Lee
  • - chungbuk national university hospital , Korea (South) lee jung hwan
  • - chungbuk university hospital , Korea (South) Hyeonmi Ryu
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Eren Hastanesi Istanbul , Turkey Armagan Sarac
  • - DAYA General Hospital,Thrissur,Kerala , India Raveendran TK
  • - CLINIQUE STE CLOTILDE , Reunion patrick MASCAREL
  • - Les cedres St malo , France nicolas gautier
  • - Private sector , Greece Vasilios Tzilas
  • - Kanto Rosai Hospital , Japan Taku Tajima
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - Kinki University Faculty of Medicine, , Japan Mitsuru Matsuki
  • - 異⑸ , Korea (South) Junghwan Kim
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - Seirei Hamamatsu General Hospital , Japan Kenichi Mizuki
  • - University of Tsukuba , Japan Toshitaka Ishiguro
  • - Medicheck health care , Korea (South) Chae Lim
  • - Chungbuk national university , Korea (South) Yong Kim
▶ Semi-Correct Answer : 2/94,  2.1%
  • - Kyungpook national university , Korea (South) Chungeun Lim
  • - Otsu Municipal Hospital , Japan Noriatsu Ichiba
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