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We report a case of an adult man who underwent surgical resection of a presumed anterior mediastinal teratoma, which upon histopathologic assessment was diagnosed as an epithelioid hemangioendothelioma (EHE). EHE is a rare vascular tumor of variable, but usually low malignant potential. Its occurrence in mediastinum is estimated at 1 in a million. As EHE often contains macroscopic fat and bone, it can be indistinguishable on imaging from mediastinal mature teratoma. Therefore, EHE should be included in differential diagnosis of fat and bone-containing mediastinal masses. Keywords: Mediastinal epithelioid hemangioendothelioma