Patients
All cases were identified through Medline from different institutions using pre-defined MeSh terms [mediastinal teratoma] OR [mature mediastinal teratoma] OR [mature teratoma]OR [immature teratoma] AND [pleural effusion] between May 2017 and November 2017. Mediastinal teratoma was diagnosed by anatomo-pathologic findings after surgery resection or during medico-legal expertise. The records of 64 patients were used for clinical analysis. We excluded two patients from whom clinical details and surgery outcomes were not obtained through our search. From full-text articles we extracted age of the patient at diagnosis, sex, country, first symptoms developed, type of surgery, anatomo-pathologic findings (mature/immature, benign/malignant, type of tissue found) as reported and patients outcomes after surgery (death/relapse). The time to diagnosis was calculated from the first onset of respiratory symptoms and the confirmation of diagnosis through histological analysis after surgery resection or autopsy. Chest X-ray and CT examination were the major tools for establishing the preoperative diagnosis. Descriptive analysis was essentially conducted for the report of the literature review. Categorical variables were expressed as proportions and continuous variables were expressed by means and standard deviations (±SD). Data were captured on a Microsoft Excel spreadsheet and exported to STATA version 14.1 (StataCorp LP, College Station, Texas 77845 USA). A written consent was secured from our patient prior the study commenced.