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Mediastinal Mature Teratoma

Cunningham PJC - MedPix (2006)

View Article: MedPix Image - MedPix Case

Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Mediastinal Mature Teratoma

History: 9 y.o. girl with several month history of dull, intermittent, substernal chest pain - relieved by sitting up and treated with NSAIDs.

Findings: • PA and lateral chest radiographs: Large, circumscribed anterior mediastinal mass abutting the ascending aorta, pulmonary artery, and left heart border. No evident adenopathy or pleural effusion. • Contrast-enhanced chest CT: Circumscribed, heterogeneous anterior mediastinal mass containing multiple components with fluid and fat attenuation but no calcifications. The mass abuts and displaces the thymus - but appears separate. No adenopathy or evidence of local invasion.

Ddx: » The differential diagnosis for a child with a mediastinal mass on CXR includes: • thymoma • thymic carcinoid • thymic carcinoma • thymic cyst • thymolipoma • lymphoma • germ cell tumors (including teratoma & seminoma) • parathyroid adenoma • lymphangioma • intrathoracic goiter » The most common of these are thymoma, germ cell tumor, substernal goiter, and lymphoma. All the other conditions are rare. » In this patient the CT appearance, especially the presence of fat, is highly specific for a teratoma. » Additionally, the lack of contiguity of the mass with the thyroid makes goiter very unlikely, the patient's sex makes a malignant germ cell tumor unlikely, the absence of adenopathy elsewhere argues against lymphoma, and her age makes thymoma unlikely.

Dxhow: Imaging, surgery, pathology

Exam: Physical examination unrevealing. EKG normal.

No MeSH data available.


The axial CT shows a normal anterior thymus (labeled) and the heterogeneous fat-containing mass - the teratoma.
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MPX2151_synpic59833: The axial CT shows a normal anterior thymus (labeled) and the heterogeneous fat-containing mass - the teratoma.


Mediastinal Mature Teratoma

Cunningham PJC - MedPix (2006)

The axial CT shows a normal anterior thymus (labeled) and the heterogeneous fat-containing mass - the teratoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2151&req=5

MPX2151_synpic59833: The axial CT shows a normal anterior thymus (labeled) and the heterogeneous fat-containing mass - the teratoma.

View Article: MedPix Image - MedPix Case

Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Mediastinal Mature Teratoma

History: 9 y.o. girl with several month history of dull, intermittent, substernal chest pain - relieved by sitting up and treated with NSAIDs.

Findings: • PA and lateral chest radiographs: Large, circumscribed anterior mediastinal mass abutting the ascending aorta, pulmonary artery, and left heart border. No evident adenopathy or pleural effusion. • Contrast-enhanced chest CT: Circumscribed, heterogeneous anterior mediastinal mass containing multiple components with fluid and fat attenuation but no calcifications. The mass abuts and displaces the thymus - but appears separate. No adenopathy or evidence of local invasion.

Ddx: » The differential diagnosis for a child with a mediastinal mass on CXR includes: • thymoma • thymic carcinoid • thymic carcinoma • thymic cyst • thymolipoma • lymphoma • germ cell tumors (including teratoma & seminoma) • parathyroid adenoma • lymphangioma • intrathoracic goiter » The most common of these are thymoma, germ cell tumor, substernal goiter, and lymphoma. All the other conditions are rare. » In this patient the CT appearance, especially the presence of fat, is highly specific for a teratoma. » Additionally, the lack of contiguity of the mass with the thyroid makes goiter very unlikely, the patient's sex makes a malignant germ cell tumor unlikely, the absence of adenopathy elsewhere argues against lymphoma, and her age makes thymoma unlikely.

Dxhow: Imaging, surgery, pathology

Exam: Physical examination unrevealing. EKG normal.

No MeSH data available.