A Unique Case of Mediastinal Teratoma with Mature Pancreatic Tissue, Nesidioblastosis, and Aberrant Islet Differentiation: a Case Report and Literature Review

Endocrine Pathology
Tanupriya AgrawalArthur S Tischler

Abstract

Mediastinal teratomas with elements of mature pancreatic tissue are rare. Only a very few cases of pancreatic tissue with nesidioblastosis in teratoma have been reported. Here, we report a case of a 12-year-old male who presented with pleural effusion and was revealed to have a large anterior mediastinal mass. Biopsy of the mass revealed benign mature teratoma. After biopsy, the teratoma ruptured into the right thoracic cavity. It was then excised and sent to pathology for further evaluation. Preoperatively, there was no evidence of hyperinsulinemia or hypoglycemia. Postoperatively, there was no change in blood glucose levels. Histologically, the mass showed large areas of mature pancreatic tissue flanking a small intestine-like structure. Numerous endocrine cell islets, poorly defined groups of neuroendocrine cells and ductular-insular complexes characteristic of nesidioblastosis were dispersed in the exocrine pancreatic parenchyma. In addition, other parts of the tumor containing keratinizing squamous epithelium with cutaneous adnexal glands, small intestine, and bronchus including cartilage and respiratory epithelium were observed. Some islets contained two or more cell types while others were monophenotypic. Immunohistochem...Continue Reading

References

Mar 1, 1989·American Journal of Clinical Pathology·N AlbersG Klöppel
Dec 1, 1960·Thorax·B T LE ROUX
Mar 2, 2006·Virchows Archiv : an International Journal of Pathology·Suhail Al-Salam, Moueid Al Ashari
Jul 15, 2009·Pathology, Research and Practice·Wilko WeichertJens C Rückert
Jul 1, 1947·American Journal of Diseases of Children·H SHERMAN
Jun 10, 2010·Laboratory Investigation; a Journal of Technical Methods and Pathology·Yuexiu WuRennian Wang

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Citations

May 28, 2019·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Kirti MagudiaMark M Hammer
May 25, 2021·Advances in Anatomic Pathology·Ziad M El-Zaatari, Jae Y Ro
Sep 12, 2021·Interactive Cardiovascular and Thoracic Surgery·Junjie ZhangYajun Lv

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