Mature mediastinal teratoma with tumor rupture into airway
A previously healthy 16-year-old girl presented with hemoptysis in the setting of a persistent cough for two months. Imaging identified a large mediastinal mass with cystic and solid components, calcifications and fat suggestive of a germ cell tumor. There was associated right middle lobe consolidat...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-06-01
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| Series: | Journal of Pediatric Surgery Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576622000975 |
| _version_ | 1811306092060213248 |
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| author | Jamie E. Anderson Mallory R. Taylor Erin K. Romberg Kimberly J. Riehle Raj Kapur Mary E. Crocker Erin E. Crotty Georgene Hergenroeder Sarah L.M. Greenberg |
| author_facet | Jamie E. Anderson Mallory R. Taylor Erin K. Romberg Kimberly J. Riehle Raj Kapur Mary E. Crocker Erin E. Crotty Georgene Hergenroeder Sarah L.M. Greenberg |
| author_sort | Jamie E. Anderson |
| collection | DOAJ |
| description | A previously healthy 16-year-old girl presented with hemoptysis in the setting of a persistent cough for two months. Imaging identified a large mediastinal mass with cystic and solid components, calcifications and fat suggestive of a germ cell tumor. There was associated right middle lobe consolidation with an air-fluid level concerning for a necrotizing pneumonia, right upper lobe bronchiectasis, hilar lymphadenopathy, and right upper lobe and right pleural-based nodules concerning for disseminated disease. Histologic analysis of a percutaneous biopsy revealed skeletal muscle, fibroadipose tissue, skin, and keratinous debris consistent with a mature germ cell tumor. Rigid and flexible bronchoscopy were performed and identified inspissated, purulent, and fibrinous material in the right upper and middle lobe bronchi. Microbial cultures grew Staphylococcus aureus. After 3 weeks of antibiotics, complete surgical resection was performed. No malignant components were identified. Her post-operative course was uncomplicated, and she remains without evidence of disease 6 months after resection. While mediastinal teratomas are common, rupture is uncommon with fewer than 60 reported cases in the literature. Rupture can be associated with inflammation and/or infection, resulting in diagnostic and treatment challenges. |
| first_indexed | 2024-04-13T08:38:13Z |
| format | Article |
| id | doaj.art-be7e365e365a45f8b23a33fd893dbb3c |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-04-13T08:38:13Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-be7e365e365a45f8b23a33fd893dbb3c2022-12-22T02:54:01ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662022-06-0181102270Mature mediastinal teratoma with tumor rupture into airwayJamie E. Anderson0Mallory R. Taylor1Erin K. Romberg2Kimberly J. Riehle3Raj Kapur4Mary E. Crocker5Erin E. Crotty6Georgene Hergenroeder7Sarah L.M. Greenberg8Department of Surgery, Division of General and Thoracic Pediatric Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA; Department of Surgery, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA; Corresponding author. Division of General and Thoracic Pediatric Surgery, Seattle Children's Hospital, PO Box 5371, Seattle, WA, 98145-5005, USA.Department of Pediatrics, Division of Hematology/Oncology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USADepartment of Radiology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USADepartment of Surgery, Division of General and Thoracic Pediatric Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA; Department of Surgery, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USADepartment of Pathology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USADepartment of Pediatrics, Division of Pulmonary and Sleep Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USADepartment of Pediatrics, Division of Hematology/Oncology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USADepartment of Pediatrics, Division of Pulmonary and Sleep Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USADepartment of Surgery, Division of General and Thoracic Pediatric Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA; Department of Surgery, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USAA previously healthy 16-year-old girl presented with hemoptysis in the setting of a persistent cough for two months. Imaging identified a large mediastinal mass with cystic and solid components, calcifications and fat suggestive of a germ cell tumor. There was associated right middle lobe consolidation with an air-fluid level concerning for a necrotizing pneumonia, right upper lobe bronchiectasis, hilar lymphadenopathy, and right upper lobe and right pleural-based nodules concerning for disseminated disease. Histologic analysis of a percutaneous biopsy revealed skeletal muscle, fibroadipose tissue, skin, and keratinous debris consistent with a mature germ cell tumor. Rigid and flexible bronchoscopy were performed and identified inspissated, purulent, and fibrinous material in the right upper and middle lobe bronchi. Microbial cultures grew Staphylococcus aureus. After 3 weeks of antibiotics, complete surgical resection was performed. No malignant components were identified. Her post-operative course was uncomplicated, and she remains without evidence of disease 6 months after resection. While mediastinal teratomas are common, rupture is uncommon with fewer than 60 reported cases in the literature. Rupture can be associated with inflammation and/or infection, resulting in diagnostic and treatment challenges.http://www.sciencedirect.com/science/article/pii/S2213576622000975Mediastinal teratomaMature teratomaRuptured teratomaPulmonary parenchymal teratoma fistula |
| spellingShingle | Jamie E. Anderson Mallory R. Taylor Erin K. Romberg Kimberly J. Riehle Raj Kapur Mary E. Crocker Erin E. Crotty Georgene Hergenroeder Sarah L.M. Greenberg Mature mediastinal teratoma with tumor rupture into airway Journal of Pediatric Surgery Case Reports Mediastinal teratoma Mature teratoma Ruptured teratoma Pulmonary parenchymal teratoma fistula |
| title | Mature mediastinal teratoma with tumor rupture into airway |
| title_full | Mature mediastinal teratoma with tumor rupture into airway |
| title_fullStr | Mature mediastinal teratoma with tumor rupture into airway |
| title_full_unstemmed | Mature mediastinal teratoma with tumor rupture into airway |
| title_short | Mature mediastinal teratoma with tumor rupture into airway |
| title_sort | mature mediastinal teratoma with tumor rupture into airway |
| topic | Mediastinal teratoma Mature teratoma Ruptured teratoma Pulmonary parenchymal teratoma fistula |
| url | http://www.sciencedirect.com/science/article/pii/S2213576622000975 |
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