Abstract Teratomas are tumours composed of tissue derived from more than one germ cell line. Intrathoracic teratomas are usually seen in the mediastinum and rarely in the lungs and comprise (1-5) % of all mediastinal tumors. We report a case of mediastinal benign cystic teratoma with polyserosal involvement in a young adult patient, who presented with fever and cough for 9 months. Initial radiographic studies did not reveal any underlying mediastinal lesion, rather presented with massive pericardial effusion with bilateral moderate pleural effusion. Despite being put on Anti-TB treatment, he was followed up with no improvement of features. A repeat CT scan of chest followed by CT guided FNAC from mediastinal mass done 9 months after the onset of symptoms showed an anterior mediastinal cystic teratoma. Keywords: Teratoma, Germ cell tumor, Pericardial effusion, Pleural effusion

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