Home   Chapter Home   Jobs   Conferences   Fellowships   Books

Advertisement

Mediastinum

Cystic lesions

Teratoma - cystic

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 24 February 2013, last major update December 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

Subtypes: immature, malignant transformation

General
=========================================================================

● Common - 10-20% of mediastinal lesions
● In anterosuperior mediastinum
● Neoplastic, not a developmental malformation
● Usually contain tissue derived from at least 2 of 3 germ cell layers - endoderm, mesoderm, ectoderm
● 50% have cough, dyspnea or chest pain
● Tumors adhering to lung, pericardium or blood vessels are either malignant or ruptured mature teratomas with inflammatory reaction

Epidemiology
=========================================================================

● Usually children or young adults (mean age 20 years)

Clinical features
=========================================================================

● May be associated with Klinefelter’s syndrome (XXY)
● Rarely associated with acute myelogenous leukemia

Gross description
=========================================================================

● Cystic with variable solid component
● Malignant tumors are often adherent to adjacent structures or have necrosis
● Benign tumors often have keratinous debris, cartilage or mucus

Case reports
=========================================================================

● 19 year old man with extrathyroidal multi-septate, predominantly cystic neck mass (J Med Case Rep 2008;2:23)
● 22 year old man with obliteration of right cardiophrenic sinus by mass (J Med Case Rep 2011;5:193)
● 28 year old woman with concomitant mature cystic teratoma in mediastinum and ovary (J Thorac Dis 2012;4:434)

Micro description
=========================================================================

● Mature squamous epithelium with cutaneous appendages (commonly), GI columnar epithelium, neuroglia, bone, cartilage, fat, striated muscle
● Also choroid plexus, hepatocytes, pancreas, retinal-type tissue
● May contain immature neuroepithelial tissue (see below)
● No cholesterol granulomas

Micro images
=========================================================================

Mature cystic teratoma

Mature teratoma

Immature teratoma

General
=========================================================================

● Contains immature neuroepithelial tissue such as embryonic tubules
● Benign behavior in patents under age 15

Mature teratoma with malignant transformation

General
=========================================================================

● Very rare
● Contain overtly malignant tissue
● Tumors with germ cell components are classified as malignant mixed germ cell tumors

Case reports
=========================================================================

● 44 year old man with adenocarcinoma with sarcomatous dedifferentiation (Pathol Res Pract 2012;208:741)
● 66 year old man with mature cystic teratoma with focal well-differentiated adenocarcinoma (Am J Clin Pathol 1994;101:531)

End of Mediastinum > Cystic lesions > Teratoma - cystic

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).