Recurrent immature mediastinal teratoma with life-threatening respiratory distress in a neonate

This case report describes a newborn with a mediastinal teratoma who presented with severe respiratory distress at birth and required emergency surgery. The mass was adherent to the pericardium and the aorta and was compressing the trachea. Histopathology proved it to be an immature teratoma. After the excision, the elevated serum alpha fetoprotein (AFP) levels dropped to normal. However, at 4 months of age the AFP level started to rise again and a recurrent lesion was detected. This was treated with Carboplatin-based chemotherapy. The child responded favorably and is well after 42 months' follow-up. Of the few patients presenting with a similar diagnosis, none recurred nor any malignancy reported. We have reviewed the literature of this clinical rarity.