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© 2002 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 21:759-765 • 0278-4297

Mature Mediastinal Teratoma

Sonographic Imaging Patterns and Pathologic Correlation

Tsu-Tuan Wu, MD, Hao-Chien Wang, MD, Yeun-Chung Chang, MD, Yung-Chie Lee, MD, Yih-Leong Chang, MD and Pan-Chyr Yang, MD, PhD

Department of Internal Medicine, Taipei County San-Chung Hospital (T.-T.W.), and Departments of Internal Medicine (H.-C.W., P.-C.Y.), Radiology (Y.-C.C.), Surgery (Y.-C.L.), and Pathology (Y.-L.C.), National Taiwan University Hospital, Taipei, Taiwan, Republic of China.

Address correspondence and reprint requests to Hao-Chien Wang, MD, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan S Rd, Taipei 100, Taiwan, Republic of China.

Objective. To characterize the sonographic patterns of teratomas located within the mediastinum and to correlate them with pathologic findings, because there have been few reports concerning the application of sonography in the diagnosis of mediastinal teratoma. Methods. Over a 9-year period, we carried out an image analysis of the sonographic findings of 28 mediastinal teratomas whose diagnoses were proved surgically. Results. Sonography showed that 18 patients had a complex mass of heterogeneous echogenicity, including regional bright echoes (n = 12), acoustic shadows (n = 8), hyperechoic lines and dots (n = 7), soft tissue septa (n = 9), dermoid plugs (n = 6), and hypoechoic areas (n = 11). This type of mediastinal teratoma revealed, in pathologic findings, varying combinations of fat, sebaceous and mucinous materials, hair, mineralized elements, and multiple compartments. Eight patients had a homogeneous hyperechoic mass, and the 2 remaining patients had floating spherules within a cystic mass. Pathologically, the homogeneous mass mainly contained hair and sebaceous material. The floating spherules were also composed of sebaceous tissue and were above the fluid of the cyst. Conclusions. On the basis of the evaluation of the sonographic and pathologic findings, we described 3 major patterns of mediastinal teratoma: a complex mass of heterogeneous echogenicity, homogeneous high echogenicity within a solid mass, and floating spherules within a cystic mass. Thus, sonography can improve the diagnosis of mediastinal teratoma. However, additional prospective studies are needed to test the sensitivity and specificity of these sonographic patterns in the diagnosis of mediastinal teratoma.

Key Words: mediastinal teratoma • pathologic entities • sonographic pattern • sonography

Abbreviations: CT, computed tomography

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Copyright © 2002 by the American Institute of Ultrasound in Medicine.