A Case of Mediastinal Teratoma Associated with Elevated Tumor Marker in Chronic Empyema.

Um, Soo Jung; Yang, Doo Kyung; Lee, Soo Keol; Son, Choonhee; Roh, Mee Sook; Kim, Ki Nam; Lee, Ki Nam; Choi, Pil Jo; Bang, Jung Heui

doi:2009.66.2.127

Tuberc Respir Dis > Volume 66(2); 2009 > Article

Case Report

Tuberculosis and Respiratory Diseases 2009;66(2):127-131.
DOI: https://doi.org/10.4046/trd.2009.66.2.127 Published online February 1, 2009.

A Case of Mediastinal Teratoma Associated with Elevated Tumor Marker in Chronic Empyema.

Soo Jung Um, Doo Kyung Yang, Soo Keol Lee, Choonhee Son, Mee Sook Roh, Ki Nam Kim, Ki Nam Lee, Pil Jo Choi, Jung Heui Bang

¹Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea. son30243@hanmail.net
²Department of Pathology, Dong-A University College of Medicine, Busan, Korea.
³Department of Radiology, Dong-A University College of Medicine, Busan, Korea.
⁴Department of Thoracic and Cardiovascular Surgery, Dong-A University College of Medicine, Busan, Korea.

Abstract

Most mediastinal teratomas are histologically well-differentiated tumors and benign. The majority of patients with a mediastinal teratoma are asymptomatic and their tumors are usually discovered incidentally on chest radiography. On rare occasions this tumor will rupture spontaneously into the adjacent organs. A 72-year-old female patient was admitted for dyspnea and she had a multiloculated pleural effusion in the left lung field. Although repeated pleural biopsy and pleural fluid cytology did not prove the presence of malignancy, we assumed that this was a malignant effusion because it revealed consistently high levels of carcinoembryonic antigen and carbohydrate antigen 19-9, and the chest CT scan did not show typical fat or bone density in the mass. Secondary infection and an uncontrolled septic condition due to pleural empyema finally compelled the patient to undergo a surgical operation. Mature teratoma was the final diagnosis and she has done well without recurrence for 2 months.

Key Words: Teratoma, Pleural effusion, Carcinoembryonic antigen