Benign teratoma are not rare. It is worth to learn about them

1. Benign Mediastinum Teratoma
Dr. K Khaing Saw Lwin
MBBS,MRCSEd,MMedSc(Thoracic Surgery)

2. • Teratomas (from Greek terato- "a monster"
and onkoma-"swelling or mass")
• germ cell tumors arising from pluripotent stem
cell
• contains tissues from all three embryological
layers e.g. endoderm, mesoderm and
ectoderm

3. • 15% of anterior mediastinal mass in adult and
about 25% in children
• 50-70% of the mediastinal germ cell tumors
• mature treratoma is more common in adults
• immature ones  children below 1 year of age

4. Types
1. mature teratomas(45%–75% of patients)
(varient dermoid cyst)
2. mature teratomas with immature elements
comprising less than 50% of the volume
3. Immature teratomas, which occur almost
exclusively in patients younger than age 15

5. • asymptomatic
• Symptomatic mass effect (respiratory
distress (infants), Horner syndrome)
• teratoma rupture chest pain, heamoptysis
or respiratory distress
• Cough productive of hair or sebum  rare
(pathognomonic of benign )

6. Imaging
• Mature teratomas
a large well-demarcated, displacing rather than
invading adjacent structures,
 cystic with septal / rim contrast enhancement
shows variable attenuation of fat, water
density cystic spaces, fat-fluid levels (specific),
homogeneous soft-tissue density and calcification

7. • Immature teratomassolid heterogeneous
mass
• Differential diagnosis:
1. mediastinal mass containing fat,
(thymolipoma)
2. Other germ cell tumors
3. lymphoma

8. • Surgical excisiontreatment of choice for
benign teratoma of the mediastinum
• Benign teratomas  resistant to radiation
and cytotoxic drugs
• recurrence is rare following complete surgical
resection

9. References
• Spectrum of Teratoma: From Head to Toe,
radiological pathological correlation(A.
Youssef)
• Hainsworth JD, Greco FA. Benign Teratomas of
the Mediastinum. In: Kufe DW, Pollock RE,
Weichselbaum RR, et al., editors. Holland-Frei
Cancer Medicine. 6th edition. Hamilton (ON):
BC Decker; 2003