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Mediastinal Mature Cystic Teratoma Presenting as a Painful Neck Swelling-A Case Report

以頸部腫痛為初徵之縱膈腔成熟囊性畸胎瘤-病例報告

摘要


縱膈腔成熟畸胎瘤是成人最常見的生殖腺外生殖細胞瘤(extragonadal germ cell tumor),且最常見於前縱膈腔;相對地,頸部並不是畸胎瘤的好香位置。我們報告一個罕見病例,為一延伸到頸部之縱膈腔成熟囊性畸胎瘤(mediastinal mature cystic teratoma)。一名28歲女性,頸部呈現漸進性疼痛腫大,且壓迫氣管並將之雄向右方。頸胸電腦斷層攝影顯示一囊性腫塊由前縱膈腔延伸至頸部區域;此病變由多樣性的組織成份構成,包含了軟組織、液體、脂肪及鈣化構造。經外科切除此囊性腫塊後,病理診斷為一成熟囊性畸胎瘤。據我們所知,縱膈腔畸胎瘤很少以頸部腫大為初徵。儘管這是一種少見的表徵,臨床醫師在診治成人頸部腫塊時,應把縱膈腔畸胎瘤列入鑑別診斷。

並列摘要


Mature teratomas of the mediastinum, the most common extragonadal germ cell tumors in adults, usually arise within the anterior mediastinum. In contrast, the neck is an uncommon site for a teratoma. We report an unusual case of mediastinal mature cystic teratoma that extended to the neck. A 28-year-old woman presented with progressive, painful neck swelling, which compressed the trachea and deviated it to the right. Computed tomography (CT) of the chest revealed a cystic mass occupying an area from the anterior mediastinum to the cervical area; the lesion consisted of multiple tissue elements, including soft tissue, fluid, fat and calcification. The cystic mass was resected and the pathological diagnosis was a mature cystic teratoma. To the best of our knowledge, a mediastinal teratoma seldom presents as a neck swelling. Although a rare manifestation, it should be considered in the differential diagnosis of neck masses in adults.

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