Thrombosis of a Teratoma: An Unusual Complication of a Usually Benign Tumor

Background: Teratomas manifest as anterior mediastinal masses in young adults with excellent prognosis after surgical resection. However, given their mediastinal location, these masses can cause life-threatening complications and require challenging surgical resections. Case Summary: A 22-year-old man was referred for persistent dyspnea with a mediastinal mass. A venous clot in transit resulted in a right atrial mass and bilateral pulmonary emboli, which prevented initial surgical intervention. The use of novel percutaneous techniques reduced his surgical risk and allowed for safe resection of the mass. Discussion: Pulmonary emboli increase perioperative mortality, but there are no definitive guidelines for their management. This case highlights the use of a multidisciplinary team and novel percutaneous therapies for perioperative pulmonary emboli and right atrial mass management. Take-Home Messages: This case demonstrates the use of percutaneous techniques for perioperative management of a right atrial mass and pulmonary emboli. Percutaneous options should be considered in the setting of an initially prohibitive surgical risk.