of huge mediastinal teratomas
Igor Motus1 and Alexander
Surgery, Urals Research Institute for Phthisiopulmpnjlogy,
Ekaterinburg, Russian Federation, 2Thoracic Surgery, Urals Research
Institute for Phthisiopulmonology, Ekaterinburg, Russian Federation
(MT) occupying more than two compartments of the mediastinum and
encroaching in the pleural spaces often pose a significant challenge in
the surgical treatment.
To present our experience and to draw attention to the main problems in
A review was performed of 17 patients with huge MT. The age was 15 to
57 years. Male/female ratio 11/6. In 5 cases exploratory thoracotomies
were earlier undertaken in other hospitals. The main reason for
inability to perform the removal was severe bleeding during the tumor
dissection. In 1 patient the tumor was recurrent after incomplete
resection. Previous biopsies showed mature MT in all cases. We
performed median sternotomy in all patients.
Read More :
tuberculosis and lung cancer
In 15 patients the tumor was removed completely. Resection of the
pericardium was necessary in 9 cases. Lobectomy or wedge lung
resections were performed in 7 cases. In 1 patient the operation was
palliative because of vena cava and atrium invasion, and in 1 patient
was exploration only. Biopsy revealed malignant transformation in these
2 patients. The blood loss was from 425 to 2530 ml (average = 690 ml)
mainly from enormously vascularised adhesions between the tumor and the
chest wall. One postoperative complication - bleeding occurred in the
patient after exploration with lethal outcome. Twelve patients are free
of disease. Two patients where malignancy was found in removed tumor
died from tumor recurrence despite irradiation and chemotherapy.
treatment of mature MT results in good outcome. Median sternotomy
provides optimal approach to the tumor origin, for great vessels and
heart protection and control bleeding during the tumor dissection from
the chest wall and lungs.
Image : https://www.healthline.com/hlcmsresource/...