Open AccessSalvage surgery using simultaneous clamshell thoracotomy with median sternotomy for mediastinal growing teratoma syndrome
Author(s) -
Kao ChiehNi,
Chou ShahHwa,
Huang ChienLin,
Lin ChihHung,
Chiang HungHsing,
Lee JuiYing,
Li HsienPin,
Chang PoChih,
Liu YuWei
Publication year - 2020
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.13297
Subject(s) - medicine , thoracotomy , surgery , median sternotomy , mediastinal shift , pneumonectomy , teratoma , perioperative , mediastinal tumor , mediastinum , lung
This report describes the case of a 17‐year‐old man who developed mediastinal growing teratoma syndrome following two cycles of chemotherapy, after an initial diagnosis of primary mediastinal nonseminomatous germ cell tumor. The large, rapidly‐growing mediastinal tumor was completely resected in conjunction with right pneumonectomy, using simultaneous clamshell thoracotomy and median sternotomy. The salvage surgery with perioperative management involved in mediastinal growing teratoma syndrome is presented here. Key points Significant findings of the study The diagnosis and surgical management are challenging for patients with mediastinal growing teratoma syndrome. Nevertheless, with proper operative planning, favorable outcomes can be attained with complete resection despite the characteristic rapid growth and massive size of these neoplasms.What this study adds In spite of postoperative sternal dehiscence, we believe that a simultaneous clamshell thoracotomy with median sternotomy approach remains a viable option for an extremely large mediastinal growing teratoma, when tumor size prevents safe resection using other approaches due to limited visualization.