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Surgical Endoscopy

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01-02-2020 | Pericardiectomy | Dynamic Manuscript

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

Authors: Richard Zheng, Courtney L. Devin, Thomas O’Malley, Francesco Palazzo, Nathaniel R. Evans III

Published in: Surgical Endoscopy | Issue 2/2020

Abstract

Background

Growing teratoma syndrome is a rare condition defined by the presence of enlarging metastatic lesions on serial imaging that arise after or during systemic chemotherapy for nonseminomatous germ cell tumors. Lesions commonly occur in the retroperitoneum, mediastinum, or lung and are notoriously unresponsive to conventional chemoradiotherapy.

Methods

In this study, we present a dynamic case of a 26-year-old male, who had undergone surgical resection and systemic bleomycin treatment for a metastatic nonseminomatous germ cell tumor, and later developed recurrent masses in his posterior mediastinum seen on surveillance imaging. Tumor markers remained normal. These lesions were resected via a right robot-assisted thoracoscopic approach with the da Vinci Xi®.

Results

The operation was completed successfully with an unremarkable postoperative hospital course. The robotic-assisted right thoracoscopic approach allowed for a minimally invasive dissection with good visualization and minimal morbidity when compared to previous cases of surgically resected mediastinal teratomas. Final pathology demonstrated mature teratomatous elements within a setting of inflammation and necrosis.

Conclusions

Robot-assisted thoracoscopic management of metastatic mediastinal lesions in the setting of this rare condition is safe and feasible.

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Title: Surgical management of growing teratoma syndrome: robotic-assisted thoracoscopic resection of mediastinal teratoma
Authors: Richard Zheng
Courtney L. Devin
Thomas O’Malley
Francesco Palazzo
Nathaniel R. Evans III
Publication date: 01-02-2020
Publisher: Springer US
Keywords: Pericardiectomy
Sternotomy
Thoracotomy
Cytostatic Therapy
Published in: Surgical Endoscopy / Issue 2/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-07177-z

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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