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Surgical Endoscopy

, Volume 34, Issue 2, pp 1019–1023 | Cite as

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

  • Richard Zheng
  • Courtney L. Devin
  • Thomas O’Malley
  • Francesco Palazzo
  • Nathaniel R. EvansIIIEmail author
Dynamic Manuscript
  • 66 Downloads

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.

Keywords

Growing teratoma syndrome Xi robot Germ cell tumor Metastatic disease 

Notes

Funding

N/A.

Compliance with ethical standards

Disclosures

Drs. Evans, Palazzo, O’Malley, Devin, and Zheng have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MPG 70468 kb)

Supplementary material 2 (MPG 110796 kb)

Supplementary material 3 (MPG 96628 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Surgery, Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Division of Thoracic and Esophageal Surgery, Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA

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