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Malignant teratoma of the mediastinum

Dermoid cyst - malignant; Nonseminomatous germ cell tumor - teratoma; Immature teratoma; GCTs - teratoma; Teratoma - extragonadal

A teratoma is a type of cancer that contains one or more of the three layers of cells found in a developing baby (embryo). These cells are called germ cells. A teratoma is one type of germ cell tumor.

The mediastinum is located inside the front of the chest in the area that separates the lungs. The heart, large blood vessels, windpipe, thymus gland, and esophagus are found there.

Causes

Malignant mediastinal teratoma occurs most often in young men in their 20s or 30s. Most malignant teratomas can spread throughout the body, and have spread by the time of diagnosis.

Blood cancers are often associated with this tumor, including:

Symptoms

Symptoms may include:

  • Chest pain or pressure
  • Cough
  • Fatigue
  • Limited ability to tolerate exercise
  • Shortness of breath

Exams and Tests

The health care provider will perform a physical exam and ask about the symptoms. The exam may reveal a blockage of the veins entering the center of the chest due to increased pressure in the chest area.

The following tests help diagnose the tumor:

  • Chest x-ray
  • CT, MRI, PET scans of the chest, abdomen, and pelvis
  • Nuclear imaging
  • Blood tests to check beta-HCG, alpha fetoprotein (AFP), and lactate dehydrogenase (LDH) levels
  • Mediastinoscopy with biopsy

Treatment

Chemotherapy is used to treat the tumor. A combination of medicines (usually cisplatin, etoposide, and bleomycin) is commonly used.

After chemotherapy is complete, CT scans are taken again to see if any of the tumor remains. Surgery may be recommended if there is a risk that the cancer will grow back in that area or if any cancer has been left behind.

Support Groups

There are many support groups available for people with cancer. Contact the American Cancer Society -- www.cancer.org.

Outlook (Prognosis)

The outlook depends on the tumor size and location and the age of the patient.

Possible Complications

The cancer can spread throughout the body and there may be complications of surgery or related to chemotherapy.

When to Contact a Medical Professional

Call your provider if you have symptoms of malignant teratoma.

References

Cheng G, Varghese TK, Park DR. Mediastinal tumors and cysts. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 83.

Putnam JB. Lung, chest wall, pleura, and mediastinum. In: Townsend CM, Beauchamp RD, Evers BM Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 57.

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  • Teratoma - MRI scan - illustration

    This MRI scan shows a tumor (teratoma) at the base of the spine (seen on the left lower edge of the screen), located in the sacrum and coccyx (sacrococcygeal) area. Teratomas are present at birth and may contain hair, teeth, and other tissues.

    Teratoma - MRI scan

    illustration

  • Malignant teratoma - illustration

    A malignant teratoma is a type of cancer consisting of cysts that contain one or more of the three primary embryonic germ layers: ectoderm, mesoderm, and endoderm. Because malignant teratomas have usually spread by the time of diagnosis, systemic chemotherapy is needed. The prognosis for people with malignant teratomas is based on the size of the tumor, its location and the age of the patient.

    Malignant teratoma

    illustration

  • Teratoma - MRI scan - illustration

    This MRI scan shows a tumor (teratoma) at the base of the spine (seen on the left lower edge of the screen), located in the sacrum and coccyx (sacrococcygeal) area. Teratomas are present at birth and may contain hair, teeth, and other tissues.

    Teratoma - MRI scan

    illustration

  • Malignant teratoma - illustration

    A malignant teratoma is a type of cancer consisting of cysts that contain one or more of the three primary embryonic germ layers: ectoderm, mesoderm, and endoderm. Because malignant teratomas have usually spread by the time of diagnosis, systemic chemotherapy is needed. The prognosis for people with malignant teratomas is based on the size of the tumor, its location and the age of the patient.

    Malignant teratoma

    illustration

 

Review Date: 7/26/2018

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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