Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7870
Peer-review started: March 29, 2021
First decision: June 24, 2021
Revised: July 6, 2021
Accepted: August 13, 2021
Article in press: August 13, 2021
Published online: September 16, 2021
Processing time: 164 Days and 14.7 Hours
Mediastinal mature teratoma is the most common histological type of primary extragonadal germ cell tumor. In this report, we describe a rare case of giant mature teratoma located primarily in the anterior mediastinum and causing partial atelectasis of the upper and middle lobes of the right lung, as well as extrinsic compression of the right atrium.
A 31-year-old male with a giant mediastinal mature teratoma presented with progressive exertional dyspnea and chest pain for 1 mo. Computed tomography of the chest indicated the diagnosis of anterior mediastinal teratoma. The patient underwent right uniportal anterior approach video-assisted thoracoscopic surgery (VATS). En bloc resection of the giant teratoma, wedge resection of the upper and middle lobes of the right lung, resection of the thymus and partial excision of the pericardium were successfully performed. The pathological diagnosis revealed a mature cystic teratoma with foreign-body reaction that was closely related to the right lung, atrium dextrum, superior vena cava and ascending aorta. An atrophic thymic tissue was also discovered at the external teratoma surface. The patient was discharged on postoperative day 7.
This is the first report of the use of uniportal VATS for complete resection of a teratoma in combination with wedge resection of the right upper and middle lung lobes and partial resection of the pericardium.
Core Tip: Mediastinal mature teratoma accounts for the majority of primary germ cell tumors in the mediastinum, which can be resected by traditional surgery. We present a rare case of mediastinal mature teratoma with complex adhesions and infiltration resected using uniportal video-assisted thoracoscopic surgery (VATS) technology. The patient had no postoperative complications and was completely asymptomatic at the first-year postoperative follow-up. As VATS currently plays an increasingly significant role in the therapy of teratomas, our report indicated that uniportal VATS for resection of mediastinal teratomas with complex adhesions and infiltration can be successfully conducted.