Pediatric Department B, Children's Hospital of Tunis, Tunisia.
Surgery Department, Charles Nicolle Hospital, Tunisia.
Afr Health Sci. 2022 Sep;22(3):317-321. doi: 10.4314/ahs.v22i3.33.
Mediastinal teratomas are rare in children. Nevertheless, they represent the most frequent mediastinal germ cell tumor. Most often, they are discovered incidentally in older children or adolescents on chest X-ray. There are other signs of discovery but less frequent: chest pain, hemoptysis and signs of mediastinal compression. Rupture into pleural space, pericardium or tracheobronchial tree are exceptional.
We report the case of 7-years old girl admitted for chest pain. The chest x-ray showed a mediastinal mass with calcifications and pleural effusion. Chest CT scan revealed a well limited heterogeneous anterior mediastinal mass with calcifications and a left pleural effusion. She underwent a median sternotomy and the tumor was completely excised. Histopathology confirmed the diagnosis of mature teratoma.
Intrapleural rupture is a rare complication of mature teratoma. Calcifications on chest imaging in afebrile children with pleural effusion should be suspected of mediastinal teratoma.
纵隔畸胎瘤在儿童中较为罕见。然而,它们是最常见的纵隔生殖细胞瘤。大多数情况下,在年龄较大的儿童或青少年的胸部 X 光片上偶然发现。还有其他发现的迹象,但不那么常见:胸痛、咯血和纵隔压迫的迹象。裂入胸膜腔、心包或气管支气管树是罕见的。
我们报告了一例 7 岁女孩因胸痛就诊。胸部 X 光片显示纵隔肿块伴钙化和胸腔积液。胸部 CT 扫描显示前纵隔肿块界限清楚,混杂,伴钙化,左侧胸腔积液。她接受了正中胸骨切开术,肿瘤被完全切除。组织病理学证实为成熟畸胎瘤的诊断。
胸腔内破裂是成熟畸胎瘤的罕见并发症。在无热的儿童中,胸腔积液伴钙化的胸部影像学检查应怀疑纵隔畸胎瘤。