Case Reports

Rupture of anterior mediastinal mature teratoma in a 16-years-old girl: A case report

I Gusti Ayu Sri Mahendra Dewi

I Gusti Ayu Sri Mahendra Dewi
Department of Pathology Anatomy, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital Denpasar-Bali. Email:
Online First: November 25, 2020 | Cite this Article
Dewi, I. 2020. Rupture of anterior mediastinal mature teratoma in a 16-years-old girl: A case report. Indonesia Journal of Biomedical Science 14(2): 108-112. DOI:10.15562/ijbs.v14i2.267

Background: Mediastinal teratomas are rare neoplasms, accounting for <10% of all mediastinal tumors. The most commonly involved site is the anterior mediastinum. In prepubertal patients, teratomas account for 58% of all germ cell tumors in the mediastinum and are usually asymptomatic in 50% of children. Tumor rupture is rare and can cause pleural effusion.

Case description: A 16-year-old girl came to the hospital with the main complaint of shortness of breath three days ago. Physical examination found an increase in the respiratory rate and pulse rate, asymmetric chest wall movement, no right pulmonary breath sounds, and an increased right vocal fremitus. Blood laboratory tests show an elevated sedimentation rate. CT imaging showed a well-defined, flat edge tumor mass with heterogeneous density in solid, cystic, fat, and calcified. The tumor measured 14.8 x 10.0 x 17.4 cm, in the anterior to the medial mediastinum, urge the heart and other mediastinal organs to the left, the collapse of the right lung's inferior lobe, and right fluidopneumothorax. The tumor was suspicious of a teratoma. Right posterolateral thoracotomy and tumor resection was performed. Macroscopically, there was a multicystic tumor mass measuring 15.5 x 14.0 x 9.0 cm with an incomplete capsule. Microscopic examination of the tumor mass showed 3 components of the germ layer, namely ectodermal, mesodermal and endodermal. No immature component appears.

Conclusion: Based on clinical features, CT imaging, macroscopic and routine histopathological examinations this case was concluded as rupture of mature teratoma.


Moreira AL, Chan JKC, Looijenga LHJ, Strobel P, Ulbright TM, Wick M. Mature and immature teratoma. In: Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG editors. WHO classification of tumours of the lung, pleura, thymus and heart. 4th edition, 7th volume, Lyon: IARC. 2015; 257-259.

Montebello A., Mizzi A., Cassar P.J., Cassar K. Benign cystic mediastinal teratoma presenting as a massive pleural effusion in a 17-year–old boy. BMJ Case Reports. 2017.

Dorterler ME, Boleken ME, Koçarslan S. A Giant Mature Cystic Teratoma Mimicking a Pleural Effusion. Hindawi Publishing Corporation Case Reports in Surgery, Volume 2016.

Mitra S, Sarma MK, Das AK. Curious case of a black pleural effusion: Mediastinal teratoma presenting as massive pleural effusion. Lung India. 2018; 35 (1): 87-89 DOI: 10.4103/lungindia.lungindia_253_17

Meshram RM, Abhisheik S, Hardas V, Siddharth K. Massive hemoptysis: A rare presentation of anterior mediastinal teratoma in an adolescent. Indian J Med Paediatr Oncol. 2017; 38 (2): 215-7 DOI: 10.4103/ijmpo.ijmpo_62_16

Yalagachin GH. Anterior mediastinal teratoma - A case report with review of literature. Indian J Sur. 2013; 75 (Suppl 1): 182-184 DOI: 10.1007/s12262-012- 0569-6

No TH, Seol S-H, G-W, Kim D-I, Yang SY, Jeong CH, Hwang Y-H, Kim JY. Benign Mature Teratoma in Anterior Mediastinum. J Clin Med Res. 2015; 7(9): 726–728. DOI: 10.14740/jocmr2270w

Liu J, Tian B, Zeng Q, Chen C, Zhou C, Li H, Shen Y, Zhao S. Mediastinal teratoma presenting with hemopthysis and pleuritis misdiagnosis as tuberculosis. BMC pediatrics. 2018; 18 (382).

Rabiou S, Efared B, Harmouchi H, Lakranbi M, Serraj M, Ouadnouni Y, Smahi M. Mature Mediastinal Teratoma: The Longue Timeline from Onset of Symptoms to Definitive Management. Clin Surg. 2018; 3: 2063.

Varma AV, Malpani G, Agrawal P, Malukani K, Dosi S. Clinicopathological spectrum of teratomas: An 8‑year retrospective study from a tertiary care institute. Indian J Cancer. 2017; 54(3): 576-579 DOI: 10.4103/ijc.IJC_294_17

Mandal G, Bhattacharya S, Dey A, Kar S, Saha S. Mature cystic teratoma of mediastinum with pleural effusion: An uncommon entity. Niger Postgrad Med J. 2016; 23(1):41-43 DOI: 10.4103/1117-1936.180183

Madhusudhan KS, Sharma R, Gadodia A, Kumar A. Spontaneous rupture of benign mediastinal teratoma: A report of two cases. Indian J Med Paediatr Oncol. 2012 ; 33(2): 123–125 DOI: 10.4103/0971-5851.99750

Serraj M, Marouane Lakranbi M, Ghalimi J, Ouadnouni Y, Smahi M. Mediastinal mature teratoma with complex rupture into the lung, bronchus and skin: a case report. World J Surg Oncol. 2013; 11: 125 DOI: 10.1186/1477-7819-11-125

Escalon JG, Arkin J, Chaump M, Harkin TJ, Wolf AS, Legasto A. Ruptured anterior mediastinal teratoma with radiologic, pathologic, and bronchoscopic correlation. Clinical imaging J. 2015; 39(4): 689-691 DOI: 10.1016/j.clinimag.2015.03.007

Tavares JG, Baptista B, Goncalves B, Raimundo P, Velho HV, Horta AB. Mediastinal teratoma rupture: A Rare Manifestation. EJCRIM. 2019; 6 DOI:10.12890/2019_001022.

No Supplementary Material available for this article.
Article Views      : 0
PDF Downloads : 0