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. 2024 Dec 20;3(1):54.
doi: 10.1186/s44215-024-00181-3.

Surgical management of a huge mediastinal mature teratoma in a 2-year-old girl: a case report

Yusuke Matsui  1   2 , Satoshi Shiono  3 , Masahiro Mizumoto  1 , Megumi Nakamura  1 , Jun Suzuki  1 , Hikaru Watanabe  1 , Tetsuro Uchida  1
Affiliations

Surgical management of a huge mediastinal mature teratoma in a 2-year-old girl: a case report

Yusuke Matsui et al. Gen Thorac Cardiovasc Surg Cases. .

Abstract

Background: Mature teratomas are benign cystic tumors that are most commonly asymptomatic. However, in some cases, mediastinal teratomas rupture the lungs and mediastinum with potentially fatal outcomes. Herein, we report a case of a large mediastinal mature teratoma that expanded to the entire left hemithorax in a child with common cold-like symptoms.

Case presentation: A 2-year-7-month old girl visited a family doctor because of cough and rhinorrhea. Chest radiography revealed a large tumor occupying the left hemithorax, necessitating transfer to our institution. Chest computed tomography (CT) revealed a large tumor with calcifications and an encapsulated surface. The lesion was 10.5 cm in size and covered the entire left hemithorax, deviating significantly from the heart. CT suggested a mature mediastinal teratoma. Considering the risk of tumor dissemination, we did not perform a diagnostic biopsy; however, surgery was performed as an oncological emergency. As ventilation and circulation were difficult to maintain during the surgery, extracorporeal membrane oxygenation was performed. During surgery, although the large tumor tightly adhered to the sternum and innominate vein, it could be safely removed from these structures, and the tumor was completely removed through median sternotomy. The pathological diagnosis revealed a benign mature mediastinal teratoma. The patient's postoperative course was uneventful.

Conclusion: As the clinical course of child-specific problems in mature teratomas tends to be severe, a surgical strategy should be meticulously planned to ensure safety.

Keywords: Children; Mature teratoma; Mediastinal tumor; Surgery.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in accordance with the ethical standards of the Helsinki Declaration of 1964 and all subsequent revisions. Consent for publication: Verbal informed consent was obtained from the patient for the publication of this case report and accompanying images, and written informed consent will be obtained by July. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Chest radiograph (A) showing a huge tumor occupying the left thoracic cavity, and the heart shadow deviated to the right side. Chest CT showing a huge tumor, 10.5 cm in size. The tumor had calcified and adipose tissue components and completely occupied the left cavity. Images are shown from B axial and C coronal views
Fig. 2
Fig. 2
A tumor is seen in the midline, and the thymus and heart are compressed to the right side
Fig. 3
Fig. 3
Macroscopic findings of cross-section of the tumor composed of hair, bone, and sebum
See this image and copyright information in PMC

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