Department of Thoracic Surgery, Norfolk and Norwich University Hospital, Norwich, United Kingdom.
Department of Thoracic Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, UK.
Multimed Man Cardiothorac Surg. 2024 Sep 18;2024. doi: 10.1510/mmcts.2024.058.
Primary mediastinal malignant germ cell tumours are rare, comprising only 1-4% of mediastinal tumours, of which 50-70% are non-seminomatous germ cell tumours. Non-seminomatous germ cell tumours typically demonstrate an excellent response to cisplatin-based chemotherapy. However, in some cases, tumours may persistently enlarge despite normal tumour markers following chemotherapy, leading to a rare condition known as growing teratoma syndrome. This poses a significant challenge for thoracic surgeons, especially when associated with infiltration of neighbouring pulmonary structures. Robot-assisted thoracoscopic surgery is not commonly employed in the resection of large mediastinal tumours. We present a case showcasing the robotic approach to complete resection of a sizeable mediastinal tumour originating from the left/main pulmonary artery, en bloc with a left upper lobectomy, pericardial resection, and reconstruction and diaphragmatic plication.
原发性纵隔恶性生殖细胞肿瘤较为罕见，仅占纵隔肿瘤的 1-4%，其中 50-70%是非精原细胞瘤生殖细胞肿瘤。非精原细胞瘤生殖细胞肿瘤对基于顺铂的化疗通常具有极好的反应。然而，在某些情况下，尽管肿瘤标志物在化疗后正常，但肿瘤仍可能持续增大，导致一种罕见的称为“生长性畸胎瘤综合征”的疾病。这对胸外科医生来说是一个重大挑战，特别是当肿瘤与邻近肺结构浸润相关时。机器人辅助胸腔镜手术通常不适用于较大纵隔肿瘤的切除术。我们报告了一例病例，展示了机器人方法在切除起源于左/主肺动脉的大纵隔肿瘤方面的应用，同时进行左上肺叶切除术、心包切除术以及重建和横膈折叠。
