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Il Giornale Italiano di Radiologia Medica 2018 Luglio-Agosto;5(4):561-4
DOI: 10.23736/S2283-8376.18.00093-1
Copyright © 2018 EDIZIONI MINERVA MEDICA
language: Italian
Mediastinal cystic teratoma in a pediatric patient
Sonia TAMASI 1 ✉, Roberta DANZI 2, Rosanna MAMONE 1, Dominga CARDAROPOLI 3, Eugenio ROSSI 1, Pasquale GRANATA 1, Rodolfo PALADINI 3, Massimo ZECCOLINI 1
1 Sezione di Radiologia, Dipartimento dei Servizi Sanitari, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon, Napoli, Italia; 2 Sezione di Radiologia, Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Napoli, Italia; 3 Unità Operativa Semplice Dipartimentale di Cardiologia Pediatrica, Dipartimento di Pediatria, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon, Napoli, Italia
Cystic teratoma is a rare germ cell tumor; in pediatric patients it is the second tumor of the anterior mediastinum, after the lymphomas. In most cases it is asymptomatic, when symptoms are present, they are due to compressive phenomena. A correct diagnosis and evaluation of the extent of the disease is essential for therapeutic purposes. Surgery, if radical, represents the treatment of first choice. In CT the cystic teratoma appears as a multicystic mass predominantly with fluid content, thin walls and internal septa with contrastographic enhancement. The differential diagnosis is with the forms lymphomas and thymomas, that usually have parenchymatous consistency, especially thymomas. CT or MRI represent diagnostic investigations with greater diagnostic accuracy. We describe a case of a small 11-month-old male patient with abdominal pain and weight loss and a volumetric increase in the thorax. Chest X-ray shows a wide mediastinal enlargement; CT shows a multiloculated multicystic mass located in the anterior mediastinum and with extension at the base of the neck. Mass determined compression and displacement of the heart, vascular axis, trachea, and esophagus. Histological examination confirmed the hypothesis of cystic teratoma of the anterior mediastinum.
KEY WORDS: Mediastinum - Computed tomography - Germ cell and embryonal neoplasms