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Joseph Junewick, MD FACR
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Anterior Mediastinal Teratoma

Case Detail

Anatomy: Chest
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CR CT
Activities:
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History

8 year old female with chest pain and shortness of breath.


Case Images


Diagnosis

Anterior Mediastinal Teratoma (mature)

Clinical Notes

Alpha Fetoprotein – 1.7 (normal 0-8)
Beta hCG – <1

Findings

CR – Well circumscribed anterior mediastinal mass.

CT – Mixed density (fat, calcium, soft tissue) anterior mediastinal mass.

Discussion

Germ cell tumors are benign or malignant lesions derived from primordial germ cells. Germ cells arise from the extraembryonic yolk sac, migrate through the dorsal mesentery to the gonadal ridge. During development the gonadal ridge is in close proximity to the spine between C6 to S2.

Teratoma is a type of germ cell neoplasm. Classically, it contains tissues derived from ectoderm, mesoderm and endoderm which are poorly organized and in various stages of maturation.

Most mediastinal teratomas are located in the anterior mediastinum. The mediastinum is the second most common site for extragonadal germ cell tumors. Mediastinal germ cell tumors are often asymptomatic but can produce airway symptoms such as cough, wheeze, hemoptosis, and dyspnea. While mature teratomas are benign, there is risk for potential degeneration and complete excision is necessary.

Reference

Ablin A and Isaacs H. Germ Cell Tumors in Priniciples and Practice of Pediatric Oncology 2nd ed Lippincott (1993).



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