Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7870-7875
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7870
Uniportal video-assisted thoracoscopic surgery for complex mediastinal mature teratoma: A case report
Xue-Lei Hu, Dong Zhang, Wen-Yong Zhu
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
Author contributions: Hu XL and Zhu WY were the patient’s doctor-in-charge, who performed the operation; Zhu WY provided the main idea of the manuscript; Hu XL and Zhang D reviewed the literature and drafted the manuscript; Zhu WY was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Yong Zhu, MD, Chief Doctor, Department of Thoracic Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, No. 758 Hefei Road, Qingdao 266035, Shandong Province, China. zhuwenyong008@163.com
Received: March 29, 2021
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
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.

Keywords: Uniportal video-assisted thoracoscopic surgery; Mediastinal mature teratoma; Complex adhesions and infiltration; Video-assisted thoracoscopic surgery; Case report

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.