Surgical Management of Giant Intrapericardial Teratoma Encasing the Coronary Artery

Minocha, Prashant K.; Hodzic, Emina; Sharma, Madhu; Bhatla, Puneet; Nielsen, James C.; Ramírez, Michelle; Magid, Margret S.; Fisher, Jason C.; Mosca, Ralph; Kumar, TK Susheel

doi:10.1177/21501351211005365

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…The mainstay of treatment is complete excision which results in an excellent prognosis ( 3 ). While complete resection is desirable, it may not be achievable especially if the tumor encases coronary arteries, and it is acceptable to leave small amounts of tumor behind ( 4 , 5 ). Following resection, periodic AFP levels and CT should be performed as recommended by the oncology team.…”

Section: Discussionmentioning

confidence: 99%

Giant mediastinal teratoma in a young infant: a case report

Howell¹,

Magid²,

Kuenzler³

et al. 2022

Mediastinum

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Background Giant mediastinal tumors in the pediatric population can pose unique challenges for resection such as cardiovascular collapse on induction of anesthesia and injury to surrounding structures that may be compressed, displaced, or invaded by the mass. Principles that must be borne in mind during removal of giant mediastinal masses include: appropriate cross-sectional imaging to define extent of mass; airway control during induction of anesthesia; a multidisciplinary collaborative approach including cardiothoracic surgery; preparation for urgent sternotomy; plan for peripheral cannulation to institute cardiopulmonary bypass if needed; preservation of neurovasculature structures during dissection; complete resection whenever possible. While complete resection is desirable and results in an excellent prognosis, it may not be achievable especially if the tumor encases coronary arteries, and it is acceptable to leave small amounts of tumor behind. Case Description Here we present a case describing surgical management of a giant mediastinal teratoma in a two-month-old female. The patient was found to have a large mediastinal mass during workup for cough and noisy breathing. She underwent preoperative echocardiogram demonstrating normal cardiac function followed by uncomplicated, open resection of the mass. Conclusions Giant mediastinal tumors give rise to unique challenges for resection in small infants. The principles of airway control, preparation for urgent sternotomy, preparation for peripheral cardiopulmonary bypass cannulation, and preservation of neurovasculature during dissection must be borne in mind.

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Section: Discussionmentioning

confidence: 99%

Giant mediastinal teratoma in a young infant: a case report

Howell¹,

Magid²,

Kuenzler³

et al. 2022

Mediastinum

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“…The primary stay of therapy is total excision, which has a very good prognosis. 9 Teratomas in the mediastinum can cause respiratory inefficiency in neonates and infants, posing a direct threat to the child's life. 10 The majority of mediastinal teratomas are operated on shortly after birth or during the first few months of life.…”

Section: Discussionmentioning

confidence: 99%

Resection of a mature giant teratoma with clamshell incision thoracotomy approach: Case report and literature review

Subianto

Arsatt

2022

Intisari Sains Medis

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Introduction: Resection of giant teratomas can be challenging. An advanced surgical technique should be designed to ensure surgical safety and complete removal of giant teratomas. We describe a case of a mature giant teratoma successfully resected with a clamshell incision thoracotomy approach. Case Description: A female, 11 years complained of shortness of breath for the last two weeks before being admitted to the hospital. Physical examination revealed a retraction of the patient's chest wall, decreased breath sounds in the left lung field, and dull percussion in the left lung field. Chest CT scan with contrast was carried out with a minimal right pleural effusion with mediastinal mass size 14 x 17 x 16 cm. The patient underwent surgery to extract the mediastinal mass; an anterior thoracotomy was performed using the Clamshell incision method on the patient's chest. Complete resection of the mass was performed. Histopathology examination was performed on the mass with the results in accordance with the description of Mature Cystic Teratoma. The patient returned home in good condition and then controlled through the outpatient polyclinic. Discussion: Clamshell incisions provide enough exposure for tumors in the mediastinum that extend into the thoracic cavity. For complete removal of a gigantic teratoma, extensive surgical and visual fields are required, as in this case. Conclusion: Clamshell incisions in anterior thoracotomy give a good surgical field and can be safely performed in patients with large mediastinal teratomas.

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Surgical Management of Giant Intrapericardial Teratoma Encasing the Coronary Artery

Cited by 2 publications

References 5 publications

Giant mediastinal teratoma in a young infant: a case report

Giant mediastinal teratoma in a young infant: a case report

Resection of a mature giant teratoma with clamshell incision thoracotomy approach: Case report and literature review

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