Benign Mediastinal Cystic Teratoma Complicated by Cardiac Tamponade due to Trauma

외상에 의하여 심장눌림증을 유발한 종격동 양성낭기형종

  • Choe Ju-Won (Department of Thoracic and Cardiovascular Surgery, Seoul Paik Hospital, Inje University College of Medicine) ;
  • Kim Yong-In (Department of Thoracic and Cardiovascular Surgery, Seoul Paik Hospital, Inje University College of Medicine)
  • 최주원 (인제대학교 의과대학 서울백병원 흉부외과) ;
  • 김용인 (인제대학교 의과대학 서울백병원 흉부외과)
  • Published : 2006.09.01

Abstract

Mediastinal teratoma is one of the most common lesions found in the anterior mediastinum, accounting for $8\sim13%$ of all mediastinal tumors. This tumor is incidentally detected by routine chest roentgengography, but pericardial perforation or pleural effusion occurs rarely. In our patient cardiac tamponade was developed due to anterior chest wall contusion, we confirmed the anterior mediastinal tumor. Vital signs were stabilized after the pericardiocentesis, and the patient underwent the tumor resection in the anterior mediastinum for a definite treatment. On histologic examination, the tumor revealed cystic structures composed of mature squamous epithelium, pilosebaceous glands, mature fat tissue, gastrointestinal mucosa, respiratory epithelium, and pancreatic tissues.

외상에 의하여 심장눌림증을 유발한 종격동 양성낭기형종 종격동 기형종은 전체 종격동 종양의 $8\sim13%$ 빈도로 발생하며, 대부분 우연히 발견되지만 드물게 심낭 천공이 발생하여 심장눌림증을 유발하거나, 흉막삼출액을 고이게 한다. 본 증례에서는 전흉벽 타박상을 받은 여자 환자에게서 심장눌림증이 발생하였고, 응급 방사선검사에서 종격전부 종양이 확인되었으며 심장막천자술을 받은 후 활력징후가 회복되어 추후 수술적 절제술로 종양을 적출하였다. 조직검사에서 피지선, 성숙 지방종, 위장관점막, 호흡기도 점막 및 췌장의 조직 등으로 구성된 낭포성 구조물로 관찰되어 양성 낭기형종으로 판정되었다.

Keywords

References

  1. Sabiston DC, Spencer FC. Chapter 17 medistinum. In: Davis RD, Oldham HN, Sabiston DC. Surgery of the chest. 6th ed. Durham: W.B. Saunders Company. 1995;583-96
  2. Serlo WS, Heikkinen E. Cardiac tamponade caused by a mediastinal teratoma. Scand J Thorac Cardiovasc Surg 1983; 17:323-25 https://doi.org/10.3109/14017438309099372
  3. Maeyama R, Uchiyama A, Tominaga R, Ichimiya H, Kuroiwa K, Tanaka M. Benign mediastinal teratoma complicated by cardiac tamponade: report of a case. Jpn J Surg 1999;29:1206-8 https://doi.org/10.1007/BF02482274
  4. Marstern JL, Cooper AG, Ankeney JL. Acute cardiac tamponade due to perforation of a benign mediastinal teratoma into the pericardial sac. Review of cardiovascular manifestations of mediastinal teratoma. J Thorac Cardiovasc Surg 1966;51:700-7
  5. Jeon YB, Sohn ST, Chun SH, et al. Mediastinal teratoma with pleural and pericardial effusion teratoma with pleural and pericardial effusion. Korean J Thorac Cardiovasc Surg 1998;31:436-9
  6. Lim SC, Kim BP, Jang WC, Oh BS. Ruptured mature cystic teratoma involving pulmonary artery. Korean J Thorac Cardiovasc Surg 2004;37:711-4
  7. Tollens T, Casselman F, Devlieger H. Fetal cardiac tamponade due to an intrapericardial teratoma. Ann Thorac Surg 1998;66:559-60 https://doi.org/10.1016/S0003-4975(98)00508-6
  8. Furukawa K, Tanaka S, Ichimiya H, Tanaka M, Sata M. Video-assisted thoracoscopic resection of a mediastinal cyst: report of a case. Surg Today 1994;24:923-5 https://doi.org/10.1007/BF01651011