Isolated intrapulmonary teratoma

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.

Intrapulmonary mature cystic teratoma of the lung: case report of a rare entity

Background

Intrapulmonary teratoma (IPT) is a rare type of extra gonadal teratoma which often presents with non-specific symptoms and can be misdiagnosed as other diseases. Here we report a patient with IPT which was initially misdiagnosed as lung hydatid cyst versus abscess.

Case presentation

We report an intrapulmonary teratoma in a 27-year-old female presenting with persistent chest pain and dyspnea since a few years prior to her admission with associated symptoms of cough and fever. Chest x-ray only showed left side massive pleural effusion and computed tomography scan of the lungs was suggestive of hydatid cyst or a lung abscess. She underwent lobectomy and postoperative histopathological study revealed IPT as the final diagnosis.

Conclusion

Due to the non-specific symptoms and rarity, IPT can be easily misdiagnosed at first. It is essential that physicians take into account the possibility of IPT when approaching a new case of lung mass.

Intrapulmonary teratoma masquerading as hydatid cyst of the lung

Intrapulmonary teratoma (IPT) is a rare mediastinal teratoma. IPT arise because of abnormal migration of pluripotent stem cells along the developing lung bud. Patients present with chest pain, hemoptysis, and trichoptysis. These tumors have the potential to rupture into adjacent pleura, pericardium, or tracheobronchial tree. The differential diagnosis includes hydatid cyst, fungal ball, lung abscess, and lung parenchymal tumor. We report a case of IPT, which was initially diagnosed as hydatid cyst of the lung due to positive hydatid serology and correlating radiological features. The role of cross-reaction of hydatid antigens with sera of cancer patients needs to be evaluated. Surgical resection of the tumor is advised to avoid complications.

"Deceiving appearances": intrapulmonary teratoma-a diagnostic challenge

Intrapulmonary teratoma is a rare and little-known disease. The present case was that of an adolescent with recurrent cough and haemoptysis. Chest radiography revealed a mass on the left lung base, and computed tomography (CT) indicated a heterogeneous tumour with a fluid component, soft parts, fat, and calcifications in the left upper lobe. Upper left lobectomy was performed; histopathological findings confirmed a mature pulmonary teratoma.