Surgical management of growing teratoma syndrome: robotic-assisted thoracoscopic resection of mediastinal teratoma

Zheng, Richard; Devin, Courtney L.; O’Malley, Thomas J.; Palazzo, Francesco; Evans, Nathaniel R.

doi:10.1007/s00464-019-07177-z

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…While there is no established consensus on the approach to resection of mediastinal teratomas, there are not many cases of robotic-assisted thoracoscopic resection published in the literature, and our case has shown that robotic-assisted thoracoscopic resection is a feasible method to resection of mediastinal teratomas, even with invasion into the lung [8][9][10].…”

Section: Discussionmentioning

confidence: 74%

Robotic-assisted thoracoscopic resection of a mature anterior mediastinal teratoma in an adult

Hsiung,

Thota,

Sambol

et al. 2024

Annsurgcaserepimages

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Germ cell tumors rarely present in the anterior mediastinum. We report a case of 43-year-old female who presented to the hospital with cough and chest pain. Computed tomography imaging showed a 7.8 cm right anterior mediastinal mass with extension to the right upper lung. A tissue biopsy was performed showing organizing fibrosis and granulomatous inflammation, scattered foreign body type multinucleated giant cells, and rare non-necrotizing epithelioid granuloma. The patient underwent complete mass resection with the da Vinci Xi® robotic surgical system (Intuitive Surgical, Inc., Sunnyvale, CA, USA). Surgical histopathology of the mass revealed benign mediastinal mature teratoma.

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Section: Discussionmentioning

confidence: 74%

Robotic-assisted thoracoscopic resection of a mature anterior mediastinal teratoma in an adult

Hsiung,

Thota,

Sambol

et al. 2024

Annsurgcaserepimages

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“…The traditional surgical approach for resection of an anterior mediastinal germ cell tumor has been via a median sternotomy [ 8 , 9 ]. However, the morbidity and mortality associated with a sternotomy has pushed surgeons towards video-assisted thoracoscopic (VATS) or robotic-assisted thoracoscopic surgery [ 2 , 10 ]. During these procedures patients are often placed in the lateral decubitus or supine positions, with the port placements being more anterior on the chest wall with supine positioning.…”

Section: Discussionmentioning

confidence: 99%

Robotic-assisted thoracoscopic resection of anterior mediastinal cystic teratoma: a case report and literature review

Ramcharran

Wallen

2022

J Cardiothorac Surg

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Background Mediastinal teratomas are rare tumors that frequently occur in the anterior mediastinum. The majority of these tumors are benign and slow growing. Due to their low malignant potential, the treatment for these tumors is surgical resection. More recently, the surgical management has shifted from invasive approaches such as a sternotomy to minimally invasive ones such as robotic-assisted thoracoscopic resections utilizing lung isolation ventilation. We present a rare case of a locally advanced mediastinal teratoma requiring resection, which was initially attempted thoracoscopically using double lung ventilation. Case presentation A 43 year-old female was found to have an anterior mediastinal mass during work-up for an intermittent cough in 2009. Chest imaging and biopsy at the time showed evidence of a cystic teratoma without concerning features. She underwent imaging surveillance until 2018, when repeat chest imaging showed increasing growth and worrisome radiologic features concerning for malignant degeneration. She underwent an elective robotic-assisted thoracoscopic resection utilizing double lung ventilation, but due to extensive involvement of the right lung, pericardium, superior vena cava, and right phrenic nerve the patient had to be repositioned and started on single lung ventilation mid-procedure to facilitate a safe and complete resection. Conclusions Anterior mediastinal teratomas can be successfully removed by robotic-assisted thoracoscopic resections utilizing single lung ventilation. Though robotic-assisted thoracoscopic resection utilizing double lung ventilation can be effective in performing certain procedures such as lung wedge resections, thymectomy, pleural biopsies and minimally invasive cardiac procedures, it is limited in removing locally advanced mediastinal tumors.

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“…Although approximately 100 cases have been reported in the English literature, a recent article found that GTS is more common than previously reported, with an incidence of 40% in patients who had already undergone surgery ( 3 , 4 ). Mostly, it occurs in the pelvic region but there are also some patients with extra-pelvic disease, such as lung, mediastinum, central nervous system, spleen and diaphragm ( 5 , 6 , 7 ).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic and imaging findings of growing teratoma syndrome

Taşkın

Turgay

Şükür

et al. 2021

J Turkish German Gynecol Assoc

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Growing teratoma syndrome (GTS) occurs during post-treatment observation of ovarian malignant germ cell tumors. The characteristic features of this syndrome are normal tumor marker levels and evident tumoral mass or implants on imaging studies. We report a case of GTS in a 22-year-old woman with a malignant germ cell tumor. After staging surgery and chemotherapy, computed tomography showed peritoneal implants. Laparoscopy was planned to exclude malignant recurrence. During laparoscopy, smooth and pink-colored lesions were seen at the lateral pelvic wall. Histopathologic evaluation reported mature teratoma tissue with extensive mature glial components. GTS is not a malignant condition and the benefit of radical surgical intervention in cases without mass-related complication is not proven. GTS should be kept in mind after primary treatment of ovarian immature teratoma.

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Surgical management of growing teratoma syndrome: robotic-assisted thoracoscopic resection of mediastinal teratoma

Cited by 6 publications

References 23 publications

Robotic-assisted thoracoscopic resection of a mature anterior mediastinal teratoma in an adult

Robotic-assisted thoracoscopic resection of a mature anterior mediastinal teratoma in an adult

Robotic-assisted thoracoscopic resection of anterior mediastinal cystic teratoma: a case report and literature review

Laparoscopic and imaging findings of growing teratoma syndrome

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