ABSTRACT
INTRODUCTION AND IMPORTANCE: Benign cystic teratoma considered an extragonadal germ cell tumor that can present at any age and mostly located in the anterior mediastinum, only 3 %-8 % are in the posterior mediastinum. Meningomyelocele is an abnormal herniation of the meninges that located in most cases posteriorly in lumbosacral spine. Cervicothoracic meningomyelocele are rare entities resemble only 1 %-5 % of all neural tube defects. The presence of both anterior meningomyelocele (MMC) an benign teratoma is very rare and this association in the thoracic column has never been mentioned before in the medical literature. CASE PRESENTATION: We present the case of a one-year-old child, who was admitted to our hospital with a complaint recurrent vomiting episode, and respiratory distress, with no improvement in symptoms after conservative treatment. Computed tomography showed an anterior heterogeneous meningomyelocele that extend posteriorly to the upper lobe of right lung tissue. MRI confirmed the presence of the meningomyelocele in addition to a heterogenous cystic structure within. Thoracotomy was indicated and the meningomyelocele was carefully resected and sent to histopathology analysis which showed the presence of a benign teratoma accompanying the meningomyelocele. CLINICAL DISCUSSION: Meningomyeloceles and teratoma are rarely associated, especially in the thoracic spine. Mediastinal tumors should be taken into consideration when a mass is found. A thorough imaging investigations is crucial in establishing the diagnosis along with histopathology after complete resection. CONCLUSION: In the presence of posterior mediastinal meningomyelocele with heterogeneity, a histopathological examination of the specimen should be performed to exclude the mediastinal tumors.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Congenital Infantile fibrosarcoma is a rare tumor in children and accounts for only 10 % of various malignant tumors in this age group. Manifestations vary according to the site of occurrence. Symptoms of the tumor located in unusual places can be misleading and obscure the actual diagnosis, which in turn may waste precious effort and time until the correct diagnosis is established. Infant malignancies should be considered to reduce the morbidity and mortality associated with this pathology. CASE PRESENTATION: We present the case of a 6-month-old infant, who was admitted to our hospital with a one-month history of high fever and dry cough, with no improvement in symptoms after treatment with antibiotics. Computed tomography showed a heterogeneous mass in the pleural cavity compressing the lung tissue, in addition to bilateral mild pleural effusion. Thoracotomy was indicated and the tumor was completely resected. CLINICAL DISCUSSION: Histopathological and Immunohistochemical approach is crucial because this type of tumor can overlap with many soft tissue sarcomas. After searching in medical literature, no published evidence of a similar case was found, and thus we managed the patient empirically, depending on the usual approach for congenital fibrosarcoma. Complete surgical resection is the golden standard of treatment, followed by chemotherapy depending on pathological findings. CONCLUSION: Clinical awareness is important in any unresponsive pneumonia and malignancies should be taken into consideration.
