The superior mediastinal approach to hepatic malignancy

A 26-year-old man presented with superior vena caval obstruction. He underwent excision of a malignant teratoma which contained benign hepatic tissue. Three years later he represented with a recurrence and underwent a second resection. Histology of the resected specimen demonstrated hepatocellular carcinoma arising in the hepatic component of the recurrent malignant teratoma intermediate.