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一例前纵隔成熟畸胎瘤伴严重炎症蔓延至颈部。

A case of anterior mediastinal mature teratoma with severe inflammatory extension into the neck.

作者信息

Keiya Tomoki, Uehara Hirofumi, Aoyagi Miho, Watanabe Atsushi

机构信息

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.

出版信息

Surg Case Rep. 2024 Nov 5;10(1):254. doi: 10.1186/s40792-024-01946-2.

Abstract

BACKGROUND

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.

CASE PRESENTATION

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.

CONCLUSIONS

Emphasizing the challenges and the importance of prompt intervention in the management of mediastinal teratomas with neck extension.

摘要

背景

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。

病例介绍

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4988/11534930/9048e77997e6/40792_2024_1946_Fig1_HTML.jpg

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