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 Table of Contents  
LETTER TO EDITOR
Year : 2016  |  Volume : 5  |  Issue : 4  |  Page : 279-280

EUS-FNA diagnosis of a rare case of esophageal teratoma


1 Department of Gastroenterology and Gastrointestinal Endoscopy, General Hospital, Sanremo, Italy
2 Department of Pathological Anatomy, General Hospital, Sanremo, Italy

Date of Web Publication5-Aug-2016

Correspondence Address:
Benedetto Mangiavillano
Gastroenterology and Gastrointestinal Endoscopy, General Hospital, Sanremo
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2303-9027.187896

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How to cite this article:
Mangiavillano B, De Ceglie A, Quilici P, Ruggeri C. EUS-FNA diagnosis of a rare case of esophageal teratoma. Endosc Ultrasound 2016;5:279-80

How to cite this URL:
Mangiavillano B, De Ceglie A, Quilici P, Ruggeri C. EUS-FNA diagnosis of a rare case of esophageal teratoma. Endosc Ultrasound [serial online] 2016 [cited 2019 Oct 19];5:279-80. Available from: http://www.eusjournal.com/text.asp?2016/5/4/279/187896

Dear Editor,

Endoscopic ultrasonography (EUS)-guided fine-needle aspiration (FNA) with tissue acquisition plays a pivotal role in the diagnosis of different diseases of the gastrointestinal tract and adjacent structures [1] and is known as well for its high accuracy and low complication rate. [2] Moreover, EUS-FNA has proven to be helpful in obtaining tissue samples from mediastinal lesions. [3],[4] Different tricks to improve the diagnostic yield of EUS-FNA have been proposed. [5]

Germ cell tumor (GCT) differs in frequency in children when compared to adults. Only a smaller proportion of GCTs are present in adults, showing different pathogenesis and features from prepubertal age. Teratoma is almost uniformly benign in children but generally malignant in the older patients. [6]

A 52-year-old man was admitted to our unit for suspicion of a mediastinal mass. At the age of 13 years he underwent orchiectomy plus retroperitoneal lymphadenectomy for an embryonal carcinoma, and 7 years ago, thoracic and left sovraclavear lymphadenectomy for teratocarcinoma metastases, followed by chemotherapy.

In March 2015, a follow-up computed tomography (CT)-positron emission tomography (PET) diagnosed a nodular mass of about 3 cm, above the right atrium, closer to the esophageal wall, not confirmed by magnetic resonance imaging (MRI), which showed only an esophageal diverticulum with a partially solid tissue.

Mediastinal EUS evidenced, at the middle third of the esophagus inside the submucosal layers, a type-mixed, ovular-shaped lesion of 3 cm, with an anechoic area and a remnant solid ipoechoic tissue, close to the ascending aorta [Figure 1]. A 25-gauge FNA, with two passes, was performed with rapid on-site evaluation (ROSE) by a pathologist [Figure 2]. Cytology showed neoplastic cells [Figure 3]. The patient was then referred to surgery, and histology diagnosed a teratoma.
Figure 1. EUS radial findings of the esophageal teratoma

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Figure 2. EUS-FNA of the esophageal teratoma

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Figure 3. Neoplastic cells revealed at cytopathology examination

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Kim EY. Fine-needle biopsy: Should this be the first choice in endoscopic ultrasound-guided tissue acquisition? Clin Endosc 2014;47:425-8.  Back to cited text no. 1
    
2.
Carrara S, Arcidiacono PG, Mezzi G, et al. Pancreatic endoscopic ultrasound-guided fine needle aspiration: Complication rate and clinical course in a single centre. Dig Liver Dis 2010;42:520-3.  Back to cited text no. 2
    
3.
Jamil LH, Kashani A, Scimeca D, et al. Can endoscopic ultrasound distinguish between mediastinal benign lymph nodes and those involved by sarcoidosis, lymphoma, or metastasis? Dig Dis Sci 2014;59:2191-8.  Back to cited text no. 3
    
4.
Mehmood S, Loya A, Yusuf MA. Clinical utility of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of mediastinal and intra-abdominal lymphadenopathy. Acta Cytol 2013;57:436-42.  Back to cited text no. 4
    
5.
Savides TJ. Tricks for improving EUS-FNA accuracy and maximizing cellular yield. Gastrointest Endosc 2009;69(Suppl):S130-3.  Back to cited text no. 5
    
6.
Ulbright TM, Young RH. Testicular and paratesticular tumors and tumor-like lesions in the first 2 decades. Semin Diagn Pathol 2014;31:323-81.  Back to cited text no. 6
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]


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