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Nusjirwan R, Hermawan K, Dewi M, Nugraha HG, Dewayani BM, Nataprawira HM. Mediastinal teratoma in children: A case series of misdiagnoses in a high-endemic tuberculosis setting. Int J Surg Case Rep 2024; 116:109307. [PMID: 38308982 PMCID: PMC10847986 DOI: 10.1016/j.ijscr.2024.109307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Mediastinal teratoma is a rare extragonadal teratoma that frequently manifests with non-specific symptoms and is commonly misdiagnosed, particularly in Indonesia, where tuberculosis (TB) is endemic. CASE PRESENTATION Herein, we present two cases of children aged 19 months and 17 years old who were referred with chronic nonspecific symptoms of cough, tachypnea, chest pain, and hemoptysis. Both children were initially diagnosed with TB and both completed anti-tuberculosis treatment. After visiting several healthcare facilities, a mediastinal mass was finally diagnosed and they all underwent thoracotomy without any further complication. The histopathology findings revealed mature teratoma. All patients had satisfactory outcomes at follow-up visits. CLINICAL DISCUSSIONS Patients presented with non-specific symptoms are often clinically diagnosed with TB. However, primary healthcare doctors should consider other differential diagnoses when a child has non-specific respiratory symptoms, especially when chest X-ray findings are nonspecific and TB workup is negative. CONCLUSIONS The diagnosis of mediastinal masses is still challenging in Indonesia, as the diagnosis requires a vast array of work-up examinations, therefore, early recognition and referral are crucial for management.
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Affiliation(s)
- Rama Nusjirwan
- Department of Surgery-Cardiothoracic Division, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Kartika Hermawan
- Department of Child Health, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.
| | - Mutiara Dewi
- Department of Child Health, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.
| | - Harry Galuh Nugraha
- Department of Radiology, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Birgitta Maria Dewayani
- Department of Pathology Anatomy, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Heda Melinda Nataprawira
- Department of Child Health, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.
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Mardani P, Kamran H, Ghaderpanah R, Geramizadeh B, Fouladi D, Shahriarirad R, Amirian A. A massive immature mediastinal teratoma treated with chemotherapy and surgical resection: a case report. J Cardiothorac Surg 2023; 18:294. [PMID: 37845684 PMCID: PMC10580578 DOI: 10.1186/s13019-023-02389-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/30/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Teratoma is a type of germ cell tumor consisting of one or multiple tissues derived from germinal layers. The location and size of the tumor can cause various presentations. Here we report one of the largest ever cases of immature cystic teratoma. CASE PRESENTATION In this report, we presented a 24-year-old patient with dyspnea, chest pain, nausea, and anorexia. A computed tomography scan revealed a giant, right-sided mass measuring about 190 × 150 × 140 mm. Chemotherapy was initiated for the patient, followed by thoracotomy. Histopathological evaluation revealed the nature of the mass to be an immature mediastinal teratoma. CONCLUSION the incidence of immature mediastinal teratoma is uncommon, and due to its rarity, the diagnosis needs more profound evaluation studies such as radiological and pathological assessments. Immature teratomas are optimally treated by a combination of chemotherapy and complete resection.
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Affiliation(s)
- Parviz Mardani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Hooman Kamran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rezvan Ghaderpanah
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bita Geramizadeh
- Shiraz Transplant Research Center (STRC), Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Damoun Fouladi
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran.
- Students Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Armin Amirian
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran
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Goyal VD, Pahade A, Misra G, Kaira V, Prajapati N. Large mediastinal/thoracic benign teratoma presenting with haemoptysis: Report of a case and review of the literature. Lung India 2023; 40:155-160. [PMID: 37006100 PMCID: PMC10174657 DOI: 10.4103/lungindia.lungindia_198_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 11/04/2022] [Accepted: 11/22/2022] [Indexed: 03/05/2023] Open
Abstract
The mediastinal teratomas can grow to a large size before becoming symptomatic. The symptoms are usually due to the compression of adjacent structures. A computed tomographic scan of the chest is the investigation of choice for making a provisional diagnosis and planning for further management. Removal of large mediastinal/thoracic teratoma can be associated with various intraoperative and postoperative complications, which can be life-threatening sometimes. We operated on a patient with a large mediastinal mass extending into the right thoracic cavity up to the costo-phrenic angle. The postoperative period was eventful and required judicious intensive care. The patient eventually recovered with conservative treatment. A literature search was done on PubMed using the keywords benign mediastinal teratoma. Case series/original articles published in the last two decades, that is, after the year 2000, were evaluated. As per the review of the literature, the prevalence of benign mediastinal teratoma may be higher in eastern countries. Thoracoscopic surgery is the preferred modality except for cases with adhesions or infiltration into surrounding structures.
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Affiliation(s)
- Vikas Deep Goyal
- Department of Surgery, Shri Ram Murti Samarak Institute of Medical Sciences, Bareilly, UP, India
| | - Akhilesh Pahade
- Department of Anesthesia, Shri Ram Murti Samarak Institute of Medical Sciences, Bareilly, UP, India
| | - Gaurav Misra
- Department of Anesthesia, Shri Ram Murti Samarak Institute of Medical Sciences, Bareilly, UP, India
| | - Vaanika Kaira
- Department of Pathology, Shri Ram Murti Samarak Institute of Medical Sciences, Bareilly, UP, India
| | - Neeraj Prajapati
- Department of Radiodiagnosis, Shri Ram Murti Samarak Institute of Medical Sciences, Bareilly, UP, India
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Beute JE, Seo GT, Saturno M, Xing MH, Mundi N, Dowling EM, Matloob A, Chen H, Khorsandi AS, Steinberger J, Urken ML. Central compartment neoplasms masquerading as thyroid tumors: Presentation of two unusual cases and review of the literature. OTOLARYNGOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.xocr.2022.100471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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5
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Zhang Z, Wang X, Zhou Z, Jiang G, Li Y. Surgical management of primary mediastinal mature teratoma: A single-center 20 years’ experience. Front Surg 2022; 9:902985. [PMID: 36132208 PMCID: PMC9483009 DOI: 10.3389/fsurg.2022.902985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThis study aims to investigate the clinical efficacy of video-assisted thoracic surgery (VATS) in treating mediastinal mature teratoma (MMT) and explore the clinical factors that increase the difficulties associated with VATS.MethodWe retrospectively reviewed 101 consecutive patients with MMT who underwent surgical excision between November 2001 and June 2021. Follow-up was done by telephone or at an outpatient clinic. The deadline for follow-up was February 2022.ResultsThe operative time, the chest tube indwelling time, and the hospital stay duration were significantly shorter in the VATS group compared with the thoracotomy group. The intraoperative and postoperative complication rates in the VATS group were lower than that of the thoracotomy group (P < .05). In thoracoscopic surgery, the clinical symptoms during the course of the disease were significantly associated with bleeding loss increasing [odds ratio (OR) = 3.562; 95% confidence interval (CI) 1.180–10.753, P = .024] and operation time extension (OR = 5.697; 95% CI 1.529–21.221, P = .010). The relationship between lesions and superior vena cava or innominate vein from preoperative CT imaging was significantly associated with bleeding loss increasing (OR = 4.629; 95% CI 1.463–14.639, P = .009). A maximal lesion diameter greater than 7 cm was significantly associated with increased risks of operation time extension (OR = 5.019; 95% CI 1.641–15.348, P = .005).ConclusionCompared with traditional thoracotomy surgery, VATS can be performed safely in selected patients with MMT. A surgical method for complete resection needs to be determined according to preoperative imaging and intraoperative conditions to reduce the unnecessary damage.
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Trabelsi I, Zarrad M, Romdhane MB, Boudaya S, Khalsi F, Boussetta K. Spontaneous intrapleural rupture of mediastinal teratoma in child. Afr Health Sci 2022; 22:317-321. [PMID: 36910395 PMCID: PMC9993273 DOI: 10.4314/ahs.v22i3.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Mediastinal teratomas are rare in children. Nevertheless, they represent the most frequent mediastinal germ cell tumor. Most often, they are discovered incidentally in older children or adolescents on chest X-ray. There are other signs of discovery but less frequent: chest pain, hemoptysis and signs of mediastinal compression. Rupture into pleural space, pericardium or tracheobronchial tree are exceptional. Case presentation We report the case of 7-years old girl admitted for chest pain. The chest x-ray showed a mediastinal mass with calcifications and pleural effusion. Chest CT scan revealed a well limited heterogeneous anterior mediastinal mass with calcifications and a left pleural effusion. She underwent a median sternotomy and the tumor was completely excised. Histopathology confirmed the diagnosis of mature teratoma. Conclusion Intrapleural rupture is a rare complication of mature teratoma. Calcifications on chest imaging in afebrile children with pleural effusion should be suspected of mediastinal teratoma.
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Affiliation(s)
- Ines Trabelsi
- Pediatric Department B, Children's Hospital of Tunis, Tunisia
| | - Marwa Zarrad
- Pediatric Department B, Children's Hospital of Tunis, Tunisia
| | | | - Sadok Boudaya
- Surgery Department, Charles Nicolle Hospital, Tunisia
| | - Fatma Khalsi
- Pediatric Department B, Children's Hospital of Tunis, Tunisia
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Boyoğlu NS, Yiğit Ö, Övünç O, Bilici S, Sünter AV. Tumor/Nodule Size Ratio: A Possible Reason for False-Negative Thyroid Cytology. ISTANBUL MEDICAL JOURNAL 2022. [DOI: 10.4274/imj.galenos.2022.62362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Peng D, Wu J, Zhang T, Chen Y, Hu Z. Increased 68Ga-FAPI Uptake by Mediastinal Benign Teratoma on 68Ga-FAPI PET/CT. Clin Nucl Med 2022; 47:437-438. [PMID: 35025788 DOI: 10.1097/rlu.0000000000004012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Mediastinal teratoma is a relatively rare disease that usually contains tissue from the endoderm, mesoderm, and ectoderm. We report a finding that mediastinal benign teratoma showed intense FAPI activity on 68Ga-FAPI PET/CT, which may lead to misdiagnosis of this benign lesion. It is necessary to realize that benign teratoma is also one of the reasons for the intense FAPI uptake in mediastinal masses, so as not to be misdiagnosed as a malignant tumor.
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Affiliation(s)
| | | | - Tao Zhang
- Department of Thoracic Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | | | - Zhi Hu
- Department of Thoracic Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Kumar R, Halder V, Ghosh S, Gaurav KP, Chatterjee D, Singh H. Anterior Mediastinal Benign Teratodermoid Tumour With Intraparenchymal Extension Through Cystobronchial Connection: A Rare Case Report. Cureus 2022; 14:e23030. [PMID: 35464503 PMCID: PMC9001853 DOI: 10.7759/cureus.23030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 12/04/2022] Open
Abstract
Asymptomatic presentation is common in benign mature mediastinal tumours. Symptoms of the above diseases are sometimes life-threatening and can cause massive hemoptysis, recurrent pulmonary infection, hypoxia related to the pulmonary parenchymal hemorrhage, or pressure effect on or more of the major bronchi. A 16-year-old boy presented with frequent episodes of hemoptysis and recurrent fever unresponsive to antimicrobials. On investigation, it was found to be a benign mature mediastinal mass with cystobronchial connection to the right middle lobe. Resection of this mass resulted in the complete recovery of the individual. An anterior mediastinal benign teratodermoid tumour with intraparenchymal extension through cystobronchial connection is very rare. Surgical resection is challenging but offers the complete cure.
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10
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Piber N, Weichert W, Hörer J, Ono M. Life-Threatening Mediastinal Teratoma of Infant Requiring Emergency Surgical Removal. Thorac Cardiovasc Surg Rep 2022; 11:e7-e10. [PMID: 35036289 PMCID: PMC8758248 DOI: 10.1055/s-0041-1726350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 01/28/2021] [Indexed: 11/25/2022] Open
Abstract
Background
Teratoma is a tumor derived from fetal germ cells with aberrant differentiation.
Case Description
A 3-month-old infant with a mediastinal tumor was referred to our heart center. She presented with progressive dyspnea, cyanosis, and the need to be manually ventilated. The computed tomography scan displayed a huge tumor restricting the distal trachea including the bifurcation. An emergent operation was performed and the tumor was completely removed. Histological examination confirmed a mature teratoma.
Conclusion
In such life-threatening situation, the early detection and the immediate operation are very important for the management of rapidly-progressing mediastinal teratomas compressing the respiratory tract.
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Affiliation(s)
- Nicole Piber
- Deutsches Herzzentrum München des Freistaates Bayern, Munchen, Bayern, Germany
| | - Wilko Weichert
- Technical University of Munich Institute of Pathology and Pathological Anatomy, Munchen, Bayern, Germany
| | - Jürgen Hörer
- Deutsches Herzzentrum München des Freistaates Bayern, Munchen, Bayern, Germany
| | - Masamichi Ono
- Deutsches Herzzentrum München des Freistaates Bayern, Munchen, Bayern, Germany
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11
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Kim SG, Jeong WG, Song SY, Lee T, Lee JE, Park HM, Kim YH. Mediastinal Teratoma: A Pictorial Essay. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:597-607. [PMID: 36238516 PMCID: PMC9514525 DOI: 10.3348/jksr.2021.0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/29/2021] [Accepted: 01/07/2022] [Indexed: 12/01/2022]
Abstract
종격동은 생식선 이외에서 발생하는 기형종의 가장 호발하는 부위로 알려져 있다. 종격동 성숙 기형종은 주로 젊은 성인에서 나타나고 남녀 간 발생 빈도의 큰 차이 없이 나타난다. 종격동 기형종은 대부분 전종격동에서 관찰되고, 일반적으로 증상을 보이지 않지만 종괴의 크기가 크거나 파열이 발생할 경우 여러 합병증이 나타날 수 있다. 종격동 기형종은 대부분 조직 검사 없이 전산화단층촬영(CT)만으로 진단될 수 있다. 하지만 파열된 기형종 혹은 악성 기형종의 경우 임상적 그리고 영상의학적으로 비전형적인 양상을 보여 진단이 어려울 수 있다. 본 종설에서는 종격동 기형종의 다양한 발현 양상을 영상 검사 소견을 중심으로 살펴보고자 한다.
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Affiliation(s)
- Sang Gyun Kim
- Department of Radiology, Chonnam National University Medical School, Gwangju, Korea
| | - Won Gi Jeong
- Department of Radiology, Chonnam National University Medical School, Gwangju, Korea
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Korea
| | - Sang Yun Song
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Korea
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Taebum Lee
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Korea
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Jong Eun Lee
- Department of Radiology, Chonnam National University Medical School, Gwangju, Korea
| | - Hye Mi Park
- Department of Radiology, Chonnam National University Medical School, Gwangju, Korea
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Korea
| | - Yun-Hyeon Kim
- Department of Radiology, Chonnam National University Medical School, Gwangju, Korea
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Zúñiga-Garza E, Aldape-Mora A, Chávez-Fernández DA, Rodríguez-Osuna JA, Onofre-Borja M, López-Saucedo RA. Giant mature cystic teratoma of the mediastinum resected by VATS: a case report. J Surg Case Rep 2021; 2021:rjab474. [PMID: 34703577 PMCID: PMC8536205 DOI: 10.1093/jscr/rjab474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022] Open
Abstract
The incidence of mediastinal teratomas is low, it’s important to recognize them between all the differential diagnoses for mediastinal tumors. The treatment is surgical resection. We report a giant mature cystic teratoma of the mediastinum in a 40-year-old woman. She presented with dyspnea, flu-like symptoms during the previous 5 days. An x-ray complemented with a chest CT scan showed a heterogeneous extrapulmonary multiloculated and predominantly fluid density tumor located at the left side of the mediastinum. The patient underwent resection by video-assisted thoracic surgery (VATS). The tumor was 15 cm in diameter with a predominant cystic component. Histologic examination revealed a mature cystic teratoma. Treatment of these tumors should attempt a complete resection. Open approaches are painful, require a longer recovery and are associated with higher morbidity. VATS has been used to treat these tumors, demonstrating the same effectiveness and advantages over open procedures.
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Affiliation(s)
- E Zúñiga-Garza
- Surgery Department, Centenario Hospital Miguel Hidalgo, Aguascalientes, México
| | - A Aldape-Mora
- Surgery Department, Centenario Hospital Miguel Hidalgo, Aguascalientes, México
| | | | - J A Rodríguez-Osuna
- Surgery Department, Centenario Hospital Miguel Hidalgo, Aguascalientes, México
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Kumar A, Kumar S, Kushwaha J, Raj V, Mishra A. Unusual Anterior Mediastinal Tumors Treated at a Tertiary Thoracic Center: A Case Series Analysis. Cureus 2021; 13:e17625. [PMID: 34646675 PMCID: PMC8486370 DOI: 10.7759/cureus.17625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/18/2022] Open
Abstract
Several tumors arise from different structures within the mediastinum. Although each type of mediastinal tumor has a predilection for a specific compartment, the progression of growth from one compartment to another can occur. The anterior mediastinum is the site of several tumors that pose interesting diagnostic and therapeutic challenges to thoracic surgeons. The anterior mediastinum is the seat of the majority of neoplastic growths within the mediastinum. Thymomas and lymphomas are the most common pathologies of the anterior mediastinum. Tumors of mesenchymal origin (hemangioma, lymphangioma, lipomas) and their malignant counterparts may occur in any of the mediastinal compartments. Less common tumors of the anterior mediastinal compartment are ectopic thyroid and parathyroid tumors, germ cell tumors, mesenchymal origin tumors, hemangiomas, and cervicomediastinal hygromas. Most of the mediastinal growths usually remain clinically silent until they become large and cause compressive symptoms. Here, we present a case series of five anterior mediastinal tumors consisting of solitary benign teratoma, fibrous benign tumor, malignant fibrosarcoma, hamartomatous chondroma, and malignant thymoma.
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Affiliation(s)
- Ambrish Kumar
- Department of Vascular Surgery, King George's Medical University, Lucknow, IND
| | - Shailendra Kumar
- Department of Thoracic Surgery, King George's Medical University, Lucknow, IND
| | - Jitendra Kushwaha
- Department of General Surgery, King George's Medical University, Lucknow, IND
| | - Vaibhav Raj
- Department of General Surgery, King George's Medical University, Lucknow, IND
| | - Archana Mishra
- Department of Thoracic Surgery, King George's Medical University, Lucknow, IND
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Cocchia R, Guggino G, Romano L, Annunziata R, Raucci A, Sorice M, Ranieri B, Russo G, Mauro C, Bossone E. A giant mediastinal teratoma: From diagnosis to complete resection and restitutio ad integrum. Monaldi Arch Chest Dis 2021; 92. [PMID: 34585559 DOI: 10.4081/monaldi.2021.1935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/06/2021] [Indexed: 11/23/2022] Open
Abstract
The current report highlights the integrated work-up of an unexpected giant mediastinal teratoma in 28 years old female. A comprehensive multi-modality imaging approach was implemented in order to define the diagnosis and tailor the most appropriate surgical intervention.
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Affiliation(s)
| | | | - Luigia Romano
- Department of General and Emergency Radiology, Antonio Cardarelli Hospital, Naples.
| | | | - Antonio Raucci
- Department of General and Emergency Radiology, Antonio Cardarelli Hospital, Naples.
| | - Mario Sorice
- Thoracic Surgery Unit, Antonio Cardarelli Hospital, Naples.
| | | | - Giuseppe Russo
- Chief Medical Officer, Antonio Cardarelli Hospital, Naples.
| | - Ciro Mauro
- Cardiology Unit, Antonio Cardarelli Hospital, Naples.
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15
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Hu XL, Zhang D, Zhu WY. Uniportal video-assisted thoracoscopic surgery for complex mediastinal mature teratoma: A case report. World J Clin Cases 2021; 9:7870-7875. [PMID: 34621840 PMCID: PMC8462243 DOI: 10.12998/wjcc.v9.i26.7870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/06/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND 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.
CASE SUMMARY 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.
CONCLUSION 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.
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Affiliation(s)
- Xue-Lei Hu
- Department of Thoracic Surgery, Qilu Hospital (Qingdao), Qingdao 266035, Shandong Province, China
| | - Dong Zhang
- Department of Thoracic Surgery, Pingdu People's Hospital, Pingdu 266770, Shandong Province, China
| | - Wen-Yong Zhu
- Department of Thoracic Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266035, Shandong Province, China
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16
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Huang J, Li L, Wang L. Woman With Fever and Chest Pain. Ann Emerg Med 2021; 77:e113-e114. [PMID: 34030785 DOI: 10.1016/j.annemergmed.2020.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Jun Huang
- Department of Echocardiography, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Li Li
- Department of Pediatrics, Changzhou Fourth People's Hospital, Changzhou Tumor Hospital Affiliated to Soochow University, Changzhou, Jiangsu Province, China
| | - Long Wang
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, Jiangsu Province, China
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Khanh HQ, Van Khoi N, Vuong NL. Long-term outcome in mediastinal malignancies: video-assisted thoracoscopic versus open surgery. Indian J Thorac Cardiovasc Surg 2020; 37:44-52. [PMID: 33442207 DOI: 10.1007/s12055-020-01023-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose There are not many studies comparing long-term oncological outcomes between video-assisted thoracoscopic surgery (VATS) and open surgery for mediastinal malignancies. This study aimed to compare perioperative and long-term outcomes of these two techniques in the treatment of mediastinal malignancies. Methods This is a retrospective study: patients with mediastinal malignancies underwent VATS or open surgery from 2010 to 2013 and were followed until 2019. The primary endpoints were long-term oncological outcomes, including tumor recurrence and mortality. Secondary endpoints were perioperative outcomes (operative duration, blood loss, pain, chest drainage duration, hospital length of stay, and complications). Results There were 36 patients in the VATS group and 49 patients in the open group. The median follow-up duration was 90 months. VATS significantly reduced operation time (84.6 versus 124.8 min), blood loss (59.8 versus 235.2 ml), postoperative pain score (4.9 versus 6.7), the duration of chest tube drainage (2.1 versus 3.1 days), and postoperative hospital stay (5.2 versus 8.0 days). The two groups were comparable regarding the recurrence rate (2.4 versus 2.1/100 person-years) and mortality rate (0.8 versus 0.9/100 person-years). Conclusion Compared with open surgery, VATS is less traumatic, reduces postoperative chest drainage, and shortens hospital stay with comparable long-term oncological outcomes. We advocate the VATS approach as a favored option for the resection of mediastinal malignancies.
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Affiliation(s)
- Huynh Quang Khanh
- Department of Thoracic Surgery, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Van Khoi
- Department of Thoracic Surgery, Cho Ray Hospital, Ho Chi Minh City, Vietnam
- Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Lam Vuong
- Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam
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