2023 World Conference on Lung Cancer (Posters)-EP14.03. Three Cases of Mediastinal Teratoma Resulting in Thoracic Perforation

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This document presents three cases of mediastinal mature teratoma resulting in thoracic perforation. Although mediastinal mature teratoma is a benign condition, emergency surgery is necessary when it perforates into the thoracic cavity and patients experience severe symptoms. The authors report on three patients who underwent surgery for ruptured mature teratomas between 2013 and 2021. All patients were diagnosed with mature teratomas at the time of their surgeries and had uneventful postoperative courses.<br /><br />Case 1 involves a 14-year-old boy who presented with chest pain after being struck by a soccer ball. A chest computed tomography revealed pleural effusion and an anterior mediastinal tumor. The patient underwent thoracoscopic tumor resection.<br /><br />Case 2 features a 40-year-old man with a history of atopic dermatitis who visited the emergency department with chest pain and dyspnea. Imaging revealed right pleural effusion and a giant tumor in the anterior mediastinum. The patient developed shock and underwent emergent thoracoscopic subtotal tumor resection. Complete resection of the residual tumor was later performed.<br /><br />Case 3 involves a 28-year-old woman admitted with upper back pain on breathing. Imaging revealed a large tumor in the anterior mediastinum compressing the trachea, superior vena cava, and left brachiocephalic vein. She underwent thoracoscopic subtotal tumor resection and subsequent median sternotomy for residual tumor resection.<br /><br />The authors emphasize the importance of immediate surgical interventions based on symptoms. In cases where there is severe inflammation between neighboring vital organs, reconstruction of great vessels may be required, even for benign tumors. A two-step surgical strategy involving tumor debulking followed by complete resection was employed when simple resection was difficult. The postoperative courses of these patients were uneventful; however, they require careful follow-up.<br /><br />Overall, this report highlights the need for emergent surgeries in patients with ruptured mediastinal mature teratomas and severe symptoms.

Asset Subtitle

Masakazu Takayama

Meta Tag

Speaker Masakazu Takayama

Topic Other Thoracic Malignancy

Keywords

mediastinal mature teratoma

thoracic perforation

emergency surgery

symptoms

ruptured mature teratomas

thoracoscopic tumor resection

pleural effusion

anterior mediastinum

subtotal tumor resection

median sternotomy