PMC9385876_01
Chest X-ray showing enlarged cardiomediastinal silhouette.
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Chest X-ray (CXR) showed displaced heart and cystic mass in the mediastinum (Figure 1).
Computed tomography angiography demonstrating large anterior mediastinal mass containing fluid, fat, and calcification most consistent with teratoma.
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Chest CT demonstrated a large mediastinal mass, likely a teratoma (Figure 2).
Intraoperative photo showing the anteriorly displaced and compressed thymus.
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The thymus was noted to be inferiorly displaced and extending to the level of the diaphragm (Figure 3).
Intraoperative photos showing the mass in situ (A) and after resection (B).
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Following dissection at the aortic isthmus, the mass was finally excised in toto (Figure 4).
Postoperative chest X-ray illustrating the cardiac silhouette and left lung field.
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A pre-discharge chest X-ray (Figure 5) and echocardiogram showed no structural abnormalities and no pericardial effusion.
Pathology. (A) Gross cystic and solid tumor components. (B) Mature brain showing differentiated neurons, glial cells and neuropil:ectoderm (hematoxylin and eosin stain; x400). (C) Mature skeletal muscle and cartilage:mesoderm (hematoxylin and eosin stain; x200). (D) Mature respiratory epithelium with cilia:endoderm (hematoxylin and eosin stain; x200).
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Pathology revealed a heterogeneous solid and cystic tumor (Figure 6A) with one benign lymph node and no areas of immaturity or yolk sac tumor. The mass contained mature elements derived from the three embryological germ cell layers (Figure 6B-6D).