Giant intrapulmonary teratoma in an infant
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CASE REPORT
Giant Intrapulmonary Teratoma in an Infant Tushar Kanti Saha, Avijit Roy, Anindya Chattopadhyay, Banasree Roy, Gobinda Mondal
Abstract Background: Teratomas are congenital tumours derived from more than one germ cell line. They commonly present as gonadal tumours. The mediastinum is a common extragonadal site. Pulmonary teratomas are a rare entity. Case report: We report the case of an 11-month-old child presenting with severe respiratory distress and a huge
mass occupying almost the entire right hemithorax.USG chest and CT scanning of the thorax along with CT-guided FNAC favoured the diagnosis of teratoma. Results: The mass was resected through a right posterolateral thoracotomy and the patient was discharged on the
10th postoperative day following an uneventful recovery. The histopathological report confirmed it to be a teratoma. Conclusion: Early diagnosis is sometimes difficult, but CT and FNAC can often prove helpful. Early surgical resection
gives a good result. To our knowledge, this is the first reported case of a giant intra-pulmonary teratoma in an infant. Key words: Giant intrapulmonary teratoma; infant; right hemithorax
Introduction
Case Description
Primary intrapulmonary teratomas have been reported with extraordinary rarity [1]. In the majority of cases, they represent metastases from malignant germ cell tumours in which former malignant histologic components had been completely eradicated with chemotherapy. Some cases of malignant teratomas are found to originate in the lung. Mature or benign teratomas without cytological malignant components are extremely uncommon; they have principally been seen as variably cystic masses in young adults. We report the case of an 11-month-old child with a giant intrapulmonary teratoma occupying the right hemithorax.
An 11-month-old girl born out of a non-consanguineous marriage was admitted with complaints of cough, cold, mild fever and respiratory distress that had manifested three weeks earlier. Her past medical or surgical history was unremarkable. The patient had been diagnosed as having pneumonia and had been treated by several physicians with different antibiotics without any sign of improvement. On examination, the child was dyspnoeic with shifting of the trachea and apical impulse towards the left. Breath sounds were diminished throughout the right chest. The liver was palpable 3 cm below the right costal margin. Chest radiography (Figure 1) revealed opacity throughout the entire right mid and lower zone, of varying density with shifting of the mediastinum to the left. The right costophrenic angle and upper two intercostal spaces were clear. Ultrasonography of the chest showed cystic and solid components in the right hemithorax. CT scanning of the thorax (Figure 2) identified a well-defined SOL with mixed attenuation (fluid, fat and calcium) measuring 7.3×11.2×8.5 cm that occupied almost the entire right hemithorax, compressing the adjacent lung and displacing mediastinal structures to the left. The distal part of the right
Tushar Kanti
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