Mediastinal Teratoma

Pathophysiology:  A germ cell tumor comprising primitive tissues and various rests. There may be elements of fat, bone etc… within them. Most commonly seen in middle-aged or elderly females. They are almost always benign, but rarely, may be malignant with local spread and metastasis.

CXR/CT Findings:

1. superior mediastinal mass
2. may have calcium, fat, and other soft tissue components within, as seen on CT
3. generally, mass on plain film non-specific.

"Aunt Sophies": generally the differential diagnosis of superior mediastinal masses

1. thymoma
2. retrosternal thyroid
3. lymphoma
4. adenopathy from many causes
5. vascular mass (eg. aneurysm)
6. duplication cysts
7. local geographic tumors (eg. fibroma, lipoma, chemdectoma etc…)
8. reactive mass reactions to adjacent bony pathology (eg. osteomyelitis and abscesses)