CTICasesAnterior Mediastinal Mature Teratoma with Prior Rupture and Inflammation
Imaging findings
Radiograph shows an anterior mediastinal mass (a "mogul" or opacity). CT confirms an anterior mediastinal mass with areas of low attenuation (fat/fluid) and internal heterogeneity, contiguous with the pericardium and surrounded by fat. Pathology revealed a mature teratoma with evidence of prior rupture and marked inflammation, including granulation tissue reaction.
Key takeaways
Anterior mediastinal teratomas can present with internal heterogeneity, including low attenuation components (fat/fluid), and may rupture, leading to acute symptoms (like chest discomfort) and a surrounding inflammatory reaction. Pathological findings can confirm evidence of prior rupture and associated inflammation. The "4 T's" (Teratoma, Thymoma, Thyroid, Lymphoma) are the classic differential for anterior mediastinal masses.
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