Presentation
Non-specific chest pain.
Patient Data
There is a large mass-like opacity in the left mid-lower hemithorax. It extends from the anterior to the posterior mediastinum, with effacement of the inferior retrosternal clear space. There are foci of high density projected in the mass superiorly, consistent with calcification.
The pleural recesses are clear. The right lung and left lung apex are clear.
S-shaped thoracic scoliosis, curving away from the mass.
Case Discussion
The diagnosis of mediastinal teratoma was confirmed post-resection of the mass. Mediastinal teratomas are the most common extra-gonadal germ cell tumor, and one of the '5Ts' when considering the differential diagnoses of anterior mediastinal masses.
Mediastinal teratomas can grow large over many years and cause local mass effects, such as scoliosis as seen in this case.
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