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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.

Other cancers are often associated with this tumor, including:

  • Acute myelogenous leukemia (AML)
  • Embryonal rhabdomyosarcoma
  • T-cell lymphoma (a type of blood cancer)
  • Myelodysplactic syndromes (group of bone marrow disorders)
  • Small cell carcinoma (a type of cancer that grows and spreads rapidly)

 

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 scans of the chest, abdomen, and pelvis
  • 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.

 
  • Teratoma - MRI scan

    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

    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

      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

      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

    A Closer Look

     

      Tests for Malignant teratoma of the mediastinum

       

         

        Review Date: 8/15/2016

        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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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