R X: Frontal radiograph shows a bulging of the superior left mediastinal line. This corrispond in the lateral radiograph to an anterior-superior mediastinal lesion
CT Shows an anterior mediastinal mass with smooth borders, higly disomogeneous, “pseudocystic” apparenace with solid tissue, fat, calcifications and enhancing mural nodules.
MR confirms the overall disomogeneous aspect of the lesion with fat content, better defines the relationship with the cardiac structures (extrapericardic) and delineate the secondary effect on the cardiac function.
CASO CLINICO
PRESENTAZIONE
A 27 year old men , is a check-up for work aptitude test .
PATHOLOGY AND FINAL DIAGNOSIS
MATURE MEDIASTINAL TERATOMA: Mediastinal teratomas is composed of mature ectodermal, mesodermal, and endodermal elements : epidermidis and subcutaneous fat with sebaceous and sweat glands , respiratory epithelium, tissue cartilagineous and lung glandular tissue . Mature Mediastinal Teratoma – grado 0 – Gonzales –Crussi
RX: Frontal radiograph shows a bulging of the superior left mediastinal line. This corrispond in the lateral radiograph to an anterior-superior mediastinal lesion
CT Shows an anterior mediastinal mass with smooth borders, higly disomogeneous, “pseudocystic” apparenace with solid tissue, fat, calcifications and enhancing mural nodules.
MR confirms the overall disomogeneous aspect of the lesion with fat content, better defines the relationship with the cardiac structures (extrapericardic) and delineate the secondary effect on the cardiac function.
FINAL DIAGNOSIS
MATURE MEDIASTINAL TERATOMA
DIFFERENTIAL DIAGNOSIS
Lymphoma (usually involvement of multiple nodal station, calcification uncommon)
Thymoma (usually omogeneous, fat content very uncommon)
Thyroid goiter (usually connected with thyroid gland)
REFFERENCES :
Smahi M, Achir A, Chafik A, et al. (2000) Mature teratoma of the mediastinum. Ann Chir 125:10965–971.
Moeller KH, Rosado-de-Christenson ML, Templeton PA. (1997) Mediastinal mature teratoma: imaging features. AJR Am J Roentgenol 169:4985–990
Lewis BD, Hurt RD, Payne WS, Farrow GM et al.: Benign teratomas of the mediastinum.
J Thorac Cardiovasc Surg .86(5):727-731, 1983.
Hainsworth JD, Greco FA.: Mediastinal germ cell neoplasms.
Roth JA, Ruckdeschel JC, Weisenburger TH (eds). Thoracic Oncology, Philadelphia, W.B. Saunders Co 478-489, 1989.
MATURE MEDIASTINAL TERATOMA
Author:
Dr. Gildo Matta;
Servizio di Radiologia, Azienda Ospedaliera Brotzu, Cagliari
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