A surgical case of a mediastinal teratoma with perforation accompanied by a marked inflammatory response

Abstract

A 20-year-old man presented with left chest pain and fever lasting for one day. Hematological examination showed a marked inflammatory response and chest CT on admission revealed a multilocular and partially solid mass in the anterior mediastinum and left pleural fluid. We suspected a mediastinal teratoma with perforation or mediastinal abscess. Meropenem was administered, and biopsy via VATS was performed. Pathological findings during the operation detected atypical cells, but we could not make a definite diagnosis. Continuing the antibiotic, the inflammatory response reduced and the mass shrank. We considered it to be a mediastinal teratoma with perforation, and subsequently performed thymo-thymectomy. The pathological findings of the secondary surgery revealed no immature part, and the diagnosis was a mature teratoma.