Intrapulmonary teratoma masquerading as hydatid cyst of the lung

Intrapulmonary mature cystic teratoma: A case report with literature review

Background

Mature intrapulmonary cystic teratomas are rare. The clinical manifestations are nonspecific and may mislead to other diseases. The radiographic findings are often perplexing. There are few complete reports on intrapulmonary teratomas, including patient history, radiologic and pathologic findings, patient management, and outcomes. We present a case report of an intrapulmonary mature cystic teratoma diagnosed at our hospital, along with an extensive review of the relevant literature.

Case presentation

A 47-year-old non-smoking female patient presented with hemoptysis and intermittent dyspnea for 5 months without fever or weight loss. Chest computed tomography revealed an inhomogeneous, hypodense, lobulated mass with internal fat, calcification, and soft tissue components. The patient underwent a left thoracotomy and left upper lobe lobectomy. Pathological examination revealed a cystic tumor containing various components, including fat, keratin debris, teeth, and hair. A diagnosis of intrapulmonary mature cystic teratoma was made. Three months after the operation, no recurrent tumor was identified, and the patient was scheduled for follow-up next year.

Conclusion

Intrapulmonary mature cystic teratomas are unusual. Owing to its general clinical symptoms and radiographic findings, it was misdiagnosed before surgery. After surgery, pathological and radiological findings confirmed the diagnosis. Therefore, intrapulmonary mature cystic teratomas should be considered in the differential diagnosis, and sufficient examinations should be conducted to rule out the condition.

Mediastinal mature cystic teratoma in a child: A case report study

INTRODUCTION

A mediastinal teratoma is a very rare disease, in which a relatively large mass grows in the space between the two lungs. Although it is a congenital abnormality, it is diagnosed late in the second or third decade. It could be benign or malignant, symptomatic or asymptomatic.

PRESENTATION OF CASE

A five-year-old child presented with an acute respiratory distress episode due to an acute infection, unresponsive to first-line antibiotics and had a history of similar recurrent pulmonary infections. On imaging, the patient showed an abnormal mediastinal mass which was speculated to be a hydatid cyst or abscess; however, it was later diagnosed during surgery as a mature mediastinal cystic teratoma.

DISCUSSION

Mediastinal tumors are slow-growing tumors that are mostly benign and asymptomatic, but sometimes they may grow, reaching a state where they can affect the neighboring anatomical structures, causing symptoms, which may lead to misdiagnosis.

CONCLUSION

Teratomas, as a differential diagnosis, should be considered in children with recurrent pulmonary infection and radiological findings that resemble masses in the chest. This emphasizes on the importance of performing detailed radiological and lab investigations to set an appropriate diagnosis to ensure a better treatment and prognosis.

Intrapulmonary mature cystic teratoma presenting with haemoptysis treated with right middle lobectomy in a low-resource setting

A teenage girl presented to our remote rural hospital with history of massive haemoptysis. A CT scan showed a spherical lesion in the right lung. Exploratory thoracotomy was performed with a provisional diagnosis of pulmonary hydatid cyst. Intraoperative findings were consistent with intrapulmonary teratoma and this was confirmed by a histopathological diagnosis of mature teratoma. Four years later, the patient presented again with recurrence of haemoptysis and a right middle lobectomy was performed. We present a report of successful management of this patient with 20-year follow-up since the first surgery, describe the pathology of this rare condition and the procedures used to treat it. We also discuss the social and economic factors that affect decision making in the management of rare conditions in remote rural areas among poor communities that are usually referred to tertiary hospitals and suggest modifications to protocols to provide effective treatment in spite of resource constraints.

Intrapulmonary mature teratoma: an unusual finding

Teratomas are tumors consisting of tissues derived from more than one germ cell line. Usual locations are sacrococcygeal region, intracranial, mediastinum, and gonads. Entirely intrapulmonary teratomas, with no mediastinal component, are rarely reported. We present the case of a 37-year-old man who presented for evaluation due to persistent and progressive intermittent cough. There was no sputum or hemoptysis. Computed tomography (CT) revealed an irregular, cystic lesion in the upper lobe of his left lung, which raised suspicion for aspergilloma. The patient underwent a left thoracotomy and, after finding a completely collapsed and hypoplastic left lung almost entirely occupied by an irregular mass, a total left pneumonectomy was performed. Pathological review reported an entirely intrapulmonary mature teratoma. Intrapulmonary mature teratomas are extremely rare, although several have been reported. Trichoptysis (expectoration of hair) is a specific finding that may help distinguish this entity from mediastinal teratomas.