<原著>術前の 11 年間, 胸部レントゲン写真で経過を観察しえた良性縦隔奇型腫の一症例

Abstract

A case of benign mediastinal teratoma which was operated after eleven years observation on chest X-P was reported with literature of genesis and origin of mediastinal teratoma. An abnormal shadow was seen in the right mediastinum on chest X-P of a 13 years old girl, who treated in pediatric section for pneumonia. She has complained cough, sputum, and fever with an abnormal pneumonic shadow on lung area, several times from 1968 to 1979. In each of these roentogenograms an abnormal shadow is seen on the right side of the cardiac shadow, which is gradually increased in size. After the treatment of pneumonia she admitted to our department for the operation of the tumor. The tumor was located between right atrium and right lower pulmonary artery, and had no direct relation with these vessels in pulmonary angiographic examinations. A cystic low density lesion was found in the anterior mediastinum in CT scan. At thoractomy in the right 4th intercostal space we found an egg sized encapsulated mass at the right side of vena cava suprior, having a steel to the right lobe of thymus. No infiltration was present to the lung or right atrium. Yellow creamy matrials with white hair was contained in the cyst with a thin capsule. Histologically, epidermoid cell layer, sebaceous glands, sweat glands and hair follicles were contained in the cyst wall, and diagnosed as a benigh teratoma. Hassal's bodies with thymic tissue was found in the steel of the tumor. No malignancy was obtained even after eleven years follow up in this case, however high possibility of malignant change of benign teratoma is a common opinion.