Presentation
Chronic cough and chest heaviness.
Patient Data
Large homogeneous radio-opacity with a broad base towards mediastinum in the right para-cardiac region, obscuring the right cardiac border. Hilar blood vessels are seen through the lesion. The adjacent ribs and vertebrae appear normal.
Findings are suggestive of anterior mediastinal mass.
Large anterior mediastinal mass on right side having soft tissue density attenuation, fat attenuation and multiple small nodular calcifications. No significant enhancement on post-contrast images. It is closely abutting the pericardium and causing mild mass effect on adjacent lung parenchyma with resultant subsegmental atelectasis of right middle lobe. Otherwise, bilateral lung appears normal. Great blood vessels of mediastinum are unremarkable.
Findings are suggestive mediastinal teratoma.
Case Discussion
Mediastinal teratomas are germ cell tumors located in the anterior mediastinum, representing the most common extra-gonadal germ cell tumors. Typical presentation in adults is in the third or fourth decade with clinical presentation of compressive symptoms on adjacent structures.
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