Superior Mediastinal Teratoma- A Case Report with review of literature

"A teratoma is a germ cell tumor composed of tissue derived from two or three germ layers-ectoderm, mesoderm, and endoderm". Teratomas are mostly found in children & young adults & usually originated in gonads & extragonadal midline tissues such as retroperitoneum, sacrococcygeal region & mediastinum. Mediastinal teratomas are relatively rare representing 3% of all tumors within the chest with an average incidence of 8 cases per year and the anterior mediastinum being the most common site for these tumors, benign teratomas form only 10% of them. We are presenting a case of 39 years old male who presented with progressive exertional dyspnea, orthopnea with frequent attacks of cough for 3years and feeling of pulsatile mass in left upper parasternal area in the last 4 months. Chest x-ray showed superior mediastinal shadow projecting to left upper chest zone and deviating the trachea to the right side of chest, provisional diagnosis was aneurysm of aortic arch. Computed tomography (CT) scan of chest and CT angiography done and revealed a superior mediastinal mass of heterogeneous opacity containing fluid, soft tissue, bones and calcification encroaching the right pulmonary artery and compressing and deviating the trachea to the right. Complete surgical removal done through left thoracotomy, Final diagnosis of a mature cystic teratoma was given on histopathology. This case is being presented here because mediastinum is a rare site for teratoma and superior mediastinal teratoma was reported in only few cases from review of literature.