Keiya Tomoki, Uehara Hirofumi, Aoyagi Miho, Watanabe Atsushi
Department of Thoracic Surgery, Hakodate Goryoukaku Hospital, 38-3 Goryokakucho, Hakodate, Hokkaido, 040-0001, Japan.
Department of Thoracic Surgery, Sapporo Medical University School of Medicine and Hospital, South 1, West 16, Chuo-Ku, Sapporo, Hokkaido, Japan.
Surg Case Rep. 2024 Nov 5;10(1):254. doi: 10.1186/s40792-024-01946-2.
We present the case of a rare occurrence of an anterior mediastinal mature teratoma extending into the neck, commonly referred to as a cervicothoracic mature teratoma.
A 19-year-old female presented with right-sided neck pain and swelling, which were found to be attributed to a 14 cm cystic lesion originating from the right thyroid lobe and extending into the mediastinum. A diagnosis of mediastinal teratoma with extension to the neck was made. Robot-assisted thymectomy was initiated but was complicated by dense tumor adherence to the superior vena cava and brachiocephalic veins, prompting a switch to a midline sternotomy. Simultaneous resection of the right thyroid lobe was performed due to inflammation. The transition to a midline sternotomy allowed successful excision of the tumor, which was confirmed to be a mature teratoma confined to the thoracic region. The patient's favorable postoperative course led to discharge on day 5 with no recurrence at nine months.
Emphasizing the challenges and the importance of prompt intervention in the management of mediastinal teratomas with neck extension.
我们报告一例罕见的前纵隔成熟畸胎瘤延伸至颈部的病例，通常称为颈胸成熟畸胎瘤。
一名19岁女性因右侧颈部疼痛和肿胀就诊，发现是由一个起源于右甲状腺叶并延伸至纵隔的14厘米囊性病变引起的。诊断为纵隔畸胎瘤并延伸至颈部。开始进行机器人辅助胸腺切除术，但因肿瘤与上腔静脉和头臂静脉紧密粘连而出现并发症，促使改为正中胸骨切开术。由于炎症，同时进行了右甲状腺叶切除术。改为正中胸骨切开术使肿瘤得以成功切除，证实为局限于胸部区域的成熟畸胎瘤。患者术后恢复良好，术后第5天出院，9个月无复发。
强调了在处理延伸至颈部的纵隔畸胎瘤时及时干预的挑战和重要性。
