Teratoma Presenting with Trichoptysis

Can Respir J Vol 21 No 6 November/December 2014 CASE PRESENTATION A 23-year-old woman, never smoker and native of Morocco was admitted for recurrent cough accompanied by persistent mucous expectoration containing dark hairs, a phenomenon also known as trichoptysis. Her medical history was unremarkable. Chest x-rays, magnetic resonance imaging and computed tomography (CT) revealed a mass in the anterosuperior mediastinum measuring 7.5 cm × 7.0 cm × 6.5 cm, containing fat-density material and air spaces revealing a direct communication with bronchial structures (Figures 1A and 1B). Gynecological examination and total-body CT scan ruled out the presence of uterine or ovarian masses. Routine laboratory tests and serum tumour markers including beta-human chorionic gonadotropin were within normal range. The patient underwent bronchoscopy examination of the anterior segment of the left upper bronchus revealing several black-pigmented hairs in the bronchial lumen admixed with whitish mucus (Figure 1 C). A diagnosis of intrathoracic teratoma of the mediastinum was suggested. The patient refused surgery, but she presented three years later with profuse trichoptysis. The surgical resection of the mass confirmed the clinical diagnosis of mature teratoma.