VATS Resection of a Large Mediastinal Teratoma Abutting Great Vessels

Abstract Mature mediastinal teratomas are rare, histologically benign tumours typically located in the anterior mediastinum. While often asymptomatic, larger teratomas may cause compressive symptoms and present surgical challenges, particularly when located near vital structures. Video-assisted thoracoscopic surgery (VATS) can be a safe and effective approach for selected patients with mediastinal teratomas, minimizing postoperative morbidity and enhancing recovery. We present a case of a 22-year-old male diagnosed with a large anterior mediastinal teratoma abutting the superior vena cava, brachiocephalic veins, aorta, and right phrenic nerve. After thorough evaluation, the patient underwent successful bilateral VATS for resection of the tumour. Postoperative recovery was uncomplicated, and histopathological examination confirmed the diagnosis of a mature teratoma. This case demonstrates the feasibility of VATS for resecting large, anatomically complex mediastinal teratomas, challenging traditional contraindications for minimally invasive surgery.