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The four most common teratogens are  tobacco, alcohol, medications and illegal drugs. Teratogens are substances that could harm a developing fetus by affecting growth and causing birth defects or death.
14 The most common extragonadal primary site is the anterior mediastinum, especially the anterosuperior portion. 15,16 Teratomas are the most common mediastinal germ cell tumors. 15,16 Mature teratomas, which represent approximately 60% to 70% of mediastinal germ cell tumors, are usually well-differentiated and benign.