Abstract
Introduction: Teratoma is a neoplasm composed of tissues derived from more than one germ layer (ectoderm, mesoderm, and endoderm). Teratomas occur in 1 in 4000 live births and are most commonly found in the sacrococcygeal, ovarian, and testicular regions, as well as in the brain and mediastinum. Mediastinal teratomas are rare, accounting for 8-13% of mediastinal tumors.
Case Presentation: A 35-year-old woman presented with left shoulder pain radiating to the shoulder for nine months and dry cough for one month. She experienced sharp chest pain worsened by inspiration and had two episodes of mild hemoptysis a month prior to presentation. A significant history included lower-segment cesarean section in 2012. Imaging revealed a left globular mass in the anterior left hemithorax. Intraoperatively, a large, firm, globular mass was found attached to the lingular segments of the left upper lobe, left pulmonary artery, and pericardium. En-bloc resection of the mass along with left upper lobectomy was performed.
Discussion: Teratomas are classified as mature or immature, and malignancy is determined by the presence of immature tissue. Symptoms arise from the compression of mediastinal structures, presenting as cough, dyspnea, chest pain, or pulmonary infections. Trichoptysis is unique to mediastinal teratomas (trichoptysis. The diagnosis is primarily based on CT imaging, which shows heterogeneous, sharply marginated masses with tissue fluid, fat, and calcium attenuation. Complete surgical removal is the treatment of choice, which is essential for confirming diagnosis and preventing complications. Histopathology confirmed a mature teratoma with benign characteristics and no malignant components.
Conclusion: This case report highlights a rare case of mature mediastinal teratoma mimicking an aspergilloma. Despite being benign, early diagnosis and surgical excision are crucial to prevent compressive symptoms and potential complications. Patients with mature teratomas typically have excellent prognoses and appropriate management.