Acute cardiac tamponade due to perforation of a benign mediastinal teratoma into the pericardial sac
Sano, S.; Shimizu, Y.; Shimizu, N.; Senou, Y.; Teramoto, S.; Taguchi, K.; Furutani, S.
Nihon Kyobu Geka Gakkai 31(4): 527-532
1983
ISSN/ISBN: 0369-4739 PMID: 6875327 Document Number: 211039
A unique case of a 37 yr old man with acute cardiac tamponade caused by perforation on a benign mediastinal teratoma into the pericardial sac is reported. After the patient experienced the 1st episode of chest pain and fever, the symptoms improved within several days. After the 2nd episode of chest pain and dyspnea, he was admitted to a hospital and received antibiotics and steroids with a diagnosis of acute pericarditis. Two months after pericarditis improved, an abnormal shadow appeared in the anterior upper mediastinum on chest X-ray. CT scan showed 3 cystic cavities in the mediastinum and the pericardial cavity. It was diagnosed as cystic tumor of the mediastinum. The chest was opened through a midsternotomy incison and the tumor was successfully removed, which was located in the pericardial sac at 2 different places and 2 secondary cystic cavities in the pericardial sac, which contained cloudy yellow fluid were present. The tumor was 9 .times. 6 .times. 3 cm in size, the upper half was solid and the lower half was cystic, which contained xanthogranulomatous tissue and a few fine hairs. The pathological diagnosis was mature cystic teratoma with chronic inflammation. Sebaceous glands, smooth muscle, an island of cartilage, pancreatic tissue and respiratory epithelium were also observed.