A case of emergency operation due to perforation of a infected mediastinal teratoma into the right middle lobe

Abstract

We report a case of emergency operation due to perforation of an infected mediastinal teratoma into the right lung. An 18-year-old man had a mass shadow in the right hilar region on chest X-ray, and chest CT revealed an anterior mediastinal tumor. On May 17, 2001, he had severe chest pain and hemosputa accompanying high grade fever. Infiltration shadow in the right middle and lower lung field was pointed out on May 20, 2001. Ultrasonography guided needle aspiration revealed that the cyst content was infected by staphylococcus aureus, and the level of amylase, lipase, and trypsin was 0 IU/L, 4 U/L, and 19 ng/L, respectively. Because the general condition of the patient became worse during hospitalization, we performed urgent resection of the mediastinal tumor and the right middle lobe. The thoracotomy demonstrated that the mediastinal tumor perforated into the middle lobe causing severe inflammation. Histopathologically, the tumor was diagnosed as benign teratoma.