Anterior Neck Swelling in a Healthy Young Man as the Tip of the Mature Mediastinal Cystic Teratoma

  • Irfan Mohamad Universiti Sains Malaysia
  • Choo Choon Sean Universiti Sains Malaysia
  • Ooi Cheng Tian Universiti Sains Malaysia
  • Ahmad Zuhdi Mamat Universiti Sains Malaysia
Keywords: Anterior neck mass, teratoma, mediastinum, abscess

Abstract

In a healthy young adult, an anterior neck mass can be derived from large variety of entity, more commonly being branchial cyst, thyroglossal duct cysts or thyroid gland in origin. Cervical extension of anterior mediastinal mass such as teratoma, thymoma or thymic cyst are uncommon but it needs to be taken into account. Differential diagnoses are narrowed down based on a comprehensive information of clinical presentations and sometimes with aids of specific imaging such as conventional chest radiography, ultrasonography and computed tomography. We report a 19-year-old man who was initially managed as an anterior neck abscess with retrosternal extension of the collection into anterior mediastinum, which was later found out to be an infected cervical cystic extension of an anterior mediastinal teratoma. Referral to cardiothoracic team was made and excision of the teratoma was made uneventfully.

Author Biographies

Irfan Mohamad, Universiti Sains Malaysia
Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus
Choo Choon Sean, Universiti Sains Malaysia
Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus
Ooi Cheng Tian, Universiti Sains Malaysia
Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus
Ahmad Zuhdi Mamat, Universiti Sains Malaysia
Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus

References

Carter BW, Marom EM, Detterbeck FC. Approaching the patient with an anterior mediastinal mass: a guide for clinicians. J Thorac Oncol 2014;9:S102-9.

Bradley Mullen, J. David Richardson. Primary anterior mediastinal tumors in children and adults. The Annals of Thoracic Surgery 1986; 42: 338 –45

Francesca Martino, Luis F. Avila, Jose L. Encinas et al. Teratomas of the neck and mediastinum in children. Pediatr Surg Int 2006; 22:627–34

Mohd Rushdan Md Noor, Tay Eng Hseon, Low Jen Hui Jeffrey. Gynaecologic Cancer: A Handbook for Students and Practitioners. CRC Press 2014; 446.

Wychulis AR, Payne WS, Clagett OT, Woolner LB. Surgical treatment of mediastinal tumors. J Thorac Cardiovasc Surg 1971;62:379–91.

Philip WP, Harrison K, Cruickshank DB. A posterior mediastinal dermoid tumor with marked anatomical differentiation. Thorax. 1954;9:245–7.

Weinberg B, Rose JS, Efremidis SC, Kirschner PA, Gribetz D. Posterior mediastinal teratoma (cystic dermoid) diagnosis by computerized tomography Chest. 1980;77:694–5.

Lewis BD, Hurt RD, Payne WS, Farrow GM, Knapp RH, Muhm JR. Benign teratomas of the anterior mediastinum. J Thorac Cardiovasc Surg 1983;86:727–31.

Billmire D, Vinocur C, Rescorla F, et al. Malignant mediastinal germ cell tumors: an intergroup study. J Pediatr Surg 2001; 36:18–24

Billmire DF, Grosfeld JL. Teratomas in childhood: analysis of 142 cases. J Pediatr Surg 1986; 21:548–51

Lakhoo K, Boyle M, Drake DP. Mediastinal teratomas: review of 15 pediatric cases. J Pediatr Surg 1993; 28:1161–4

Published
2018-09-22