Obstructive and severe septic shock following a ruptured mature mediastinal teratoma

Most mature mediastinal teratomas are not symptomatic until they rupture, and the mechanisms underlying their rupture remain controversial. A 40-year-old woman was admitted to the emergency room with increasing respiratory distress 24 h before admission. Her clinical examination results indicated systemic inflammatory response syndrome with jugular venous distension and bilateral pitting edema on her lower extremity. Thoracic computed tomography confirmed a well-defined anterior mediastinal giant heterogenous mass (22 x 17 x 15