Giant anterior mature mediastinal teratoma with gastrointestinal tract organoid differentiation: A rare presentation

A teratoma is a tumour with tissue or organ components resembling normal derivatives of more than one germ layer.1 Anterior mediastinal teratoma with organoid structures is a rare presentation of germ cell tumour. We report a case of such a rare giant tumour (30 × 15 cm) in a young adult male of 18 years who presented with right-sided chest pain of 3 years duration. Surgical removal is the definitive treatment of a mature anterior mediastinal teratoma. The patient was operated successfully with complete removal of the tumour. As superior vena cava (SVC) was encased in the tumour wall causing SVC syndrome, partial resection of the pericardium was required to free SVC from the tumour. The defect in the Pericardium was repaired to prevent herniation of heart. In the Post-operative period, patient developed recurrent pneumothorax of the left side, which was successfully treated by intercostal tube drainage and pleurodesis. Post resection histopathology examination confirmed mature teratoma with representation from all the three germ layers including organoid differentiation of gastrointestinal tract.