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I read with interest the observation by Bikhazi et al¹ that the dissection of a benign cervical teratoma in a 10-year-old boy "was made more difficult by the adherence of its capsule to the surrounding soft tissue." I recently reported a case of a benign cervical teratoma in an adult that was notable because it was densely adherent to the structures of the carotid sheath, the innominate vein, the trachea, and the prevertebral fascia.² This type of tissue reaction is frequently encountered in benign mediastinal teratomas. In an article describing the Mayo Clinic experience with 86 cases of benign mediastinal teratomas, Lewis and colleagues³ reported that virtually every tumor was densely adherent to vital intrathoracic structures, including the pericardium, the pleura, the lung, the great vessels, and the chest wall; and for this reason, in 7 cases, only partial removal could be accomplished. Cases involving the spontaneous rupture of benign . . . [Full Text of this Article]