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We report on a nine-month-old girl who presented with persisting cough, and diminished ventilation of the left hemithorax. Viral pneumonia was suspected after Adenovirus detection by PCR, but chest X-rays showed a persistent shadowing of the left hemithorax and persistent coughing despite clinical improvement. Because of the discrepancy between clinical and radiological signs further investigations by ultrasound and CT scan were performed, which visualized an intrathroracic tumor. Histopathology confirmed diagnosis of a teratoma. Teratomas are germ cell tumors that arise in children from a variety of locations. They are considered tumors that originate from primordial cells with the potential to differentiate into many different types of tissue [1]. The most common sites in children include saccrococcygeal (40%), ovary (25%), testicle (12%), brain (5%) and rarely other locations [2]. In more than half of the patients mediastinal teratomas present with unspecific symptoms or are asymptomatic. Often, they are discovered on radiological evaluation by chance [3]. In the thoracic cavity they can be easily missed or may masquerade as pneumonic infiltrations. Reported complications are due to intrathoracic compression effects, rupture of the tumor or secretion of hormones. Early diagnosis and resection is favored. Here, we report on a nine-month-old girl that presented in our outpatient clinic with symptoms of an airway infection, and suspected pneumonia.

Persisting Cough as the Single Presenting Symptom of an Intrathoracic Tumor in a Nine-Month-Old Child with Adenovirus Airway Infection