Life-threatening giant mediastinal cystic teratoma in a 4-month-old male baby.

Cystic teratomas of the mediastinum are rare and present with severe respiratory distress during childhood. Aspiration of the cyst is indicated to reduce the cyst volume, alleviate the patient's symptoms, and secure an operative field. This report describes a 4-month-old male baby with a large anterior mediastinal teratoma presenting with severe respiratory distress. The cystic teratoma was large enough to cause pectus carinatum. Respiratory distress secondary to airway obstruction was markedly reduced by percutaneous aspiration of the cyst. Surgical excision is indicated for a malignant or benign well-demarcated mass in any part of the mediastinum. In our patient, total surgical excision was performed. Preoperatively, percutaneous aspiration was performed twice, with the symptoms being reduced after each aspiration. Surgical excision is the best means of diagnosing and treating a benign teratoma. Percutaneous cyst aspiration not only improved ventilation but also facilitated easy excision of the cyst during surgical management.