PURPOSE: Congenital pulmonary airway malformation (CPAM)—a rare developmental anomaly—affects the lower respiratory tract in newborns. By comparing the reliability of diagnostic tools and identifying predictive factors for symptoms, we provide comprehensive clinical data for the proper management of CPAM. METHODS: We reviewed the medical records of 66 patients with prenatally diagnosed CPAM delivered at Severance Children's Hospital between January 2005 and July 2017. RESULTS: We enrolled 33 boys and 33 girls. Their mean gestational age and birth weight were 38.8 weeks and 3,050 g, respectively. Prenatal ultrasonography and postnatal radiography, lung ultrasonography, and chest computed tomography (CT) showed inconsistent findings. Chest CT showed superior sensitivity (100%) and positive predictive value (90%). Among the 66 patients, 59 had postnatally confirmed CPAM, three had pulmonary sequestration, one had cystic teratoma, and one had a normal lung. Of the 59 patients with CPAM, 21 (35%; mean age, 23.4 months) underwent surgery, including 15 who underwent video-assisted thoracoscopy. Twenty-five and 12 patients exhibited respiratory symptoms at birth and during infancy, respectively. Apgar scores and mediastinal shift on radiography were significantly associated with respiratory symptoms at birth. However, none of the factors could predict respiratory symptoms during infancy. CONCLUSION: Radiography or ultrasonography combined with chest CT can confirm an unclear or inconsistent lesion. Apgar scores and mediastinal shift on radiography can predict respiratory symptoms at birth. However, symptoms during infancy are not associated with prenatal and postnatal factors. Chest CT combined with periodic symptom monitoring is important for diagnosing and managing patients with prenatally diagnosed CPAM and to guide appropriate timing of surgery.
Birth Weight ; Bronchopulmonary Sequestration ; Cystic Adenomatoid Malformation of Lung, Congenital ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Lung ; Medical Records ; Parturition ; Radiography ; Respiratory System ; Teratoma ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; Ultrasonography, Prenatal

Mediastinal teratomas have been reported to mimic pleural effusions on chest radiography. Further evaluation of such tumours using computed tomography usually yields diagnostic characteristics that distinguish them from pleural collections. We report a patient with a mediastinal teratoma that mimicked a massive left pleural effusion on chest radiography and computed tomography.
Adult ; Contrast Media ; Female ; Humans ; Mediastinal Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Pleural Effusion ; Radiography, Thoracic ; Teratoma ; diagnosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

We report an unusual case of 9.5-cm-sized embryonal rhabdomyosarcoma arose from a mediastinal mature teratoma in a 46-yr-old man. A man presented with chest trauma as a result of an accident at 10 September 2011. On chest X-ray, an anterior mediastinal mass was detected. To obtain further information, chest computed tomography (CT) with contrast enhancement was performed, revealing an anterior mediastinal mass. Complete surgical excision was performed and entire specimen was evaluated. Pathologic diagnosis was embryonal rhabdomyosarcoma arising in mature cystic teratoma. After surgical excision, two cycles of dactinomycin-based chemotherapy were performed. Lung metastasis was detected on follow up CT in September 2012, and wedge resection was performed. Pathological finding of the lung lesion showed same feature with that of primary rhabdomyosarcoma.
Antibiotics, Antineoplastic/therapeutic use ; Dactinomycin/therapeutic use ; Desmin/metabolism ; Humans ; Immunohistochemistry ; Lung Neoplasms/radiography/secondary/surgery ; Male ; Mediastinal Neoplasms/*diagnosis/pathology ; Middle Aged ; Neoplasms, Germ Cell and Embryonal/drug therapy/*radiography/surgery ; Rhabdomyosarcoma, Embryonal/drug therapy/*radiography/surgery ; Teratoma/*diagnosis/pathology ; Tomography, X-Ray Computed

A extragonadal malignant teratoma of the extremity is a rare pheonemenon. We describe a extremely rare case of malignant teratoma of the left proximal humerus in a 14-yr-old female. Radiologic evaluations, including magnetic resonance imaging, suggested a malignant bone tumor, but a pathological examination revealed an immature bony teratoma. Bone scintigraphy and positron emission tomography computed tomography scan showed increased uptake of proximal humerus but no other abnormal lesion.
Adolescent ; Bone Neoplasms/*diagnosis/pathology/radiography ; Female ; Humans ; *Humerus/radiography ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Teratoma/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed

A malignant transformation or a tumor rupture is a rare complication of ovarian mature cystic teratoma (MCT). A tumor rupture in a malignant-transformed MCT has never been reported in the literature. We present the CT images of a 39-year-old woman showing a large, predominantly cystic mass in the lower abdomen, with fat-fluid-level ascites. A contrast-enhanced solid component, with regional discontinuity within the cystic lesion, is also demonstrated. The pathologic diagnosis of the ruptured MCT unveils the malignant transformation (squamous cell carcinoma) and mesenteric carcinomatosis.
Adult ; Cell Transformation, Neoplastic/pathology ; Diagnosis, Differential ; Female ; Humans ; Ovarian Neoplasms/*pathology/*radiography/surgery ; Teratoma/*pathology/*radiography/surgery ; *Tomography, X-Ray Computed

Mediastinal tumors are uncommon in the pediatric age group and teratoma comprises 5 percent of mediastinal lesions developing in the anterior mediastinum. It is characterized by staying asymptomatically till adulthood and the most common symptoms of mediastinal teratoma are chest pains, dyspnea, and coughs due to the compression of adjacent airways. Untreated benign teratoma can cause complications such as atelectasis of the lung, adjacent tissue compression, infection and rupture of mass. The diagnosis can be made by chest radiography and chest CT, and the treatment of choice is surgical. We report a 2 year, 10 months male patient who presented with coughs, respiratory difficulty caused by pleural effusion due to rupture, and perforation of the mass. The diagnosis was made by chest radiography and chest CT and he underwent surgical resection successfully.
Chest Pain ; Cough ; Diagnosis ; Dyspnea ; Humans ; Lung ; Male ; Mediastinal Neoplasms ; Mediastinum ; Pleural Effusion* ; Pulmonary Atelectasis ; Radiography ; Rupture ; Teratoma* ; Thorax ; Tomography, X-Ray Computed

Pleuropulmonary blastoma (PPB) is a rare malignant dysontogenetic neoplasm primarily affecting children and is characterized histologically by a variably mixed blastematous and sarcomatous patterns. We herein report a very exceptional adult case of PPB. A 21-yr-old male patient presented with a left chest pain of two weeks' duration. A computed tomography scan revealed a large, multicystic tumor occupying the left lower hemithorax, leading to the impression of a ruptured mediastinal cystic teratoma. A thoracotomy for resection of the tumor was performed. On histologic examination, the tumor consisted of cystic walls and associated solid lesions which showed undifferentiated blastemal tissues with focal fibrosarcomatous and rhabdoid features. Immunohistochemically the tumor cells only showed diffuse strong positivity for vimentin. The histologic findings corresponded to a type II PPB. The authors suggest that PPB, especially of type I or II, should be included in the radiologic differential diagnosis of mediastinal cystic neoplasms in a young adult.
Adult ; Diagnosis, Differential ; Human ; Immunohistochemistry ; Lung Neoplasms/*diagnosis/radiography/surgery ; Male ; Pulmonary Blastoma/*diagnosis/radiography/surgery ; Teratoma/*diagnosis/*radiography/surgery ; Tomography, X-Ray Computed ; Vimentin/biosynthesis

A rare case of intraventricular germinoma in the third ventricle, which occurred 30 months after total removal of mature teratoma on the same location in a 29- yr-old man is presented. Recurrence is supposed to represent an acceleration of localized dysplastic processes of totipotent germ cells present in the midline neuraxis or a growth of unidentified microscopic residue of germinoma component in mature teratoma. Although the radiation therapy after total removal of mature teratoma is still controversial, careful follow-up is warranted for evaluating a possible recurrence of other germ cell tumors.
Adult ; Cerebral Ventricle Neoplasms/classification/pathology/*radiography/surgery ; Germinoma/classification/pathology/*radiography/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasms, Second Primary/classification/pathology/*radiography/surgery ; Teratoma/complications/*surgery ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

Malignant transformation of teratoma in the anterior mediastinum is rare; the mass usually has a long history and is seen in older patients. We report a case of teratoma with malignant transformation in the anterior mediastinum, complicated by rupture. CT revealed a lobulated, inhomogeneous cystic mass with a fat com-ponent and wall calcifications. The lateral wall was disrupted and consolidation in the adjacent left upper lobe was noted, suggesting rupture. A heterogeneously enhanced solid portion, obliterating the fat plane between the mass and the great vessels was present in the medial aspect of the mass, and pathologic examina-tion demonstrated the presence of adenocarcinoma.
Adenocarcinoma/pathology ; Human ; Male ; Mediastinal Neoplasms/pathology/*radiography ; Mediastinum/pathology ; Middle Age ; Rupture, Spontaneous ; Teratoma/pathology/*radiography

Gastric teratomas are extremely rare neoplasms and almost exclusively benign. They occur predominantly in males and generally present as a palpable abdominal mass. To our knowledge, only one adult case has been described in the Korean literature. We report a case in which an immature gastric teratoma in a 3-month-old boy was revealed by CT and US.
Case Report ; Human ; Infant ; Male ; Stomach Neoplasms/*epidemiology/radiography/ultrasonography ; Teratoma/*epidemiology/radiography/ultrasonography ; Tomography, X-Ray Computed