A unique case of a 40-year-old woman with cough and gruel-like sputum by perforation on the mediastinal teratoma into the lung is reported. Her chest roentgenogram showed a mass shadow in the left hilus and segmental consolidation adjacent to the lower part of the mass shadow. CT scan showed also a capsulated inhomogeneous mass in the anterior mediastinum. The mediastinal tumor and the left upper lobe of the lung were resected by thoracotomy. The mass shadow on her chest roentgenogram was identified as teratoma. Segmental consolidation adjacent to the lower part of the mass shadow was identified as pneumoina and atelectasis caused by perforation on the mediastinal teratoma into the lung.