Mediastinum
Cystic lesions
Teratoma-cystic
Author: Hanni Gulwani, M.B.B.S.
Last author update: 1 December 2012
Last staff update: 22 March 2023
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: Teratoma cystic mediastinum
Table of Contents
Definition / general | Epidemiology | Clinical features | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Immature teratoma | Mature teratoma with malignant transformationCite this page: Gulwani H. Teratoma-cystic. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/mediastinumteratoma.html. Accessed March 26th, 2023.
Definition / 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 syndrome (XXY)
- Rarely associated with acute myelogenous leukemia
Case reports
- 19 year old man with extrathyroidal multiseptate, 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)
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
Microscopic (histologic) 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 Immature teratoma below)
- No cholesterol granulomas
Microscopic (histologic) images
Images hosted on other servers:
Mature cystic teratoma
Mature teratoma
Immature teratoma
Mature teratoma with malignant transformation
Definition / general
Case reports
- 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)
