PMC6015667_01
PMC6015667_02
Chest radiography showing large homogeneous mediastinal opacity with mediastinal enlargement.
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fig1
Echocardiography showing a 15 cm heart mass compressing the two atria.
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fig2
CT scan showing aspects of mediastinal teratoma: a combined cystic-solid tumour with walls of variable thickness.
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fig3
The combination of fluid, soft tissue, a fat-fluid level produced by high lipid content in the cyst fluid as seen in our case is a rare but diagnostic sign (Figure 3). This tumour was repressing the heart and the thymus to the left side, the pulmonary veins to the back, and the aorta and the pulmonary artery to the back (Figure 3).
Gross examination: the opened mass showed a double component: a cystic and a fleshy one, with an outcome of a mucous material at the opening ((a)-(b)).
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fig4
In the time of examination of the open mass, we found a double component; a cystic and a fleshy component (Figure 4).
Histological examination of the resected mass [HE.GX20]: (a) regular glandular gastric mucosa into sclerotic and muscular tissue. (b) Hepatic regular tissue. (c) Pancreatic tissue showing pancreatic islets of Langerhans. (d) Columnar pseudo-stratified-ciliated respiratory epithelioma. (e) Mature nervous tissue. (f) Pericardium with strips of Malpighian epithelioma.
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fig5
It includes cystic cavities lined by a ciliated respiratory epithelioma, a gastric mucosa surrounded by soft muscle bundles, a regular Malpighian epithelioma, a mature nervous tissue, pancreatic tissue, and hepatic tissue (Figure 5).