Last update:
01-Aug-2025

Teratomas are the most frequent of mediastinal germ cell tumors, but the mature ones are uncommon and more often incidentally detected; the malignant predominate in males. We reported the case study of a 54-year-old diabetic and hypertensive woman who presented with an acute episode of chest pain and dyspnea, peripheral edema, hypophonetic cardiac sounds, and normal heart rate and arterial blood pressure. Imaging studies showed a huge mediastinal cystic lesion with calcified walls, pericardial effusion, ectasia in the inferior vena cava, and partial collapse of the right lung. She had urgent pericardial fluid drainage and total resection of the mature cystic teratoma with malignant degeneration to pancreato-biliary adenocarcinoma confirmed by the carcinoembryonic antigen and CDX2 positivity. After the postoperative bronchoaspiration she had a cardiorespiratory arrest promptly reversed, but died due to the encephalic injury, sepsis, and a refractory circulatory shock.

Key words: Cardiac tamponade, Malignant degeneration, Mediastinal teratoma.