Malignant teratoma of the mediastinum
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.
Dermoid cyst - malignant; Nonseminomatous germ cell tumor - teratoma; Immature teratoma; GCTs - teratoma; Teratoma - extragonadal
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 may include:
- Chest pain or pressure
- 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
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.
There are many support groups available for people with cancer. Contact the American Cancer Society -- www.cancer.org
The outlook depends on the tumor size and location and the age of the patient.
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.
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.
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.