OBJECTIVE: The main aim of this article is to illustrate the silent evolution of an anterior mediastinal teratoma for over 70 years without presenting any notable complications.
METHODS: We present the case of a 70-year-old female, treated for hypertension referred to our department for managing a voluminous mediastinal mass, discovered fortuitously by a general practitioner in a chest X-ray. The anamnesis didn\'t relate any chest pain, cough, dyspnea nor hemoptysis. The clinical examination, in particular pleuropulmonary, was unremarkable. The workup (Chest X-Ray and CT scan) demonstrated a voluminous pleural mass at the expense of the right mediastinal pleura, rounded in shape, with calcified wall and fluid content. Blood tests did not demonstrate eosinophilia, and hydatid IgG serology was negative. serum human chorionic gonadotropin (hCG) and alpha fetoprotein (AFP) levels were found to be normal. The patient subsequently underwent a right posterolateral thoracotomy with resection of the lesion. The mass was dissected very carefully and then resected in toto. The macroscopic and microscopic histological examination demonstrated a mature cystic teratoma. Surgical resection was an adequate treatment and the prognosis was excellent for the patient.
CONCLUSIONS: Cystic mature teratomas are rare thoracic tumors, often recognized by radiological examination. This article relates the silent evolution that a teratoma could have, and the late appearance of symptoms that it could have.
目的:本文的主要目的是说明70多年来前纵隔畸胎瘤的无症状演变,而没有出现任何明显的并发症。
方法:我们介绍一个70岁的女性,因高血压而接受治疗,转诊至我们部门管理大量纵隔肿块,由全科医生在胸部X光检查中偶然发现。回忆与胸痛无关,咳嗽,呼吸困难也不咯血。临床检查,特别是胸膜肺,平淡无奇。检查(胸部X线和CT扫描)显示以牺牲右纵隔胸膜为代价的大量胸膜肿块,圆形,钙化壁和液体含量。血液检查没有显示嗜酸性粒细胞增多,包虫IgG血清学阴性。血清人绒毛膜促性腺激素(hCG)和甲胎蛋白(AFP)水平正常。患者随后接受了右后外侧开胸手术,切除了病变。非常仔细地解剖了肿块,然后全部切除。宏观和微观组织学检查显示成熟的囊性畸胎瘤。手术切除是一种适当的治疗方法,患者的预后良好。
结论:囊性成熟畸胎瘤是罕见的胸部肿瘤,通常通过放射学检查来识别。这篇文章涉及畸胎瘤可能具有的沉默进化,以及它可能出现的症状的晚期。