Key result
Anaesthesia management using a volume-restricted postoperative ventilation strategy and ERAS protocol successfully prevented re-expansion pulmonary oedema in a 15-year-old female undergoing excision of a massive ovarian teratoma.
Why the study?
Growing teratoma syndrome of the ovary associated with ascites and bilateral pleural effusion had not been reported in a paediatric age group, presenting anaesthetic challenges.
Case Report (n=1)
Careful preoperative optimization and volume-restricted postoperative ventilation are crucial for the successful anesthetic management of giant ovarian teratoma with respiratory compromise.
Paediatric growing teratoma syndrome with ascites and effusions requires tailored anaesthetic planning; this first case leaves optimal strategies open.
Rarely, an ovarian tumour will develop the growing teratoma syndrome. Growing teratoma syndrome of the cystic type has been linked to difficulties with anaesthesia because of the abdominal pressure the tumour exerts on the thorax. There haven't been any reports of this kind of ovarian tumour associated with ascites and bilateral pleural effusion in a paediatric age group. Here, we describe our anaesthetic experience in a case of developing solid-type ovarian teratoma syndrome with deranged lung status and haemodynamics. The patient was a 15-year-old female who was diagnosed with ovarian teratoma. She was scheduled for surgery when she arrived at our hospital with a 13 cm solid mass and respiratory distress. The patient's liver profile was abnormal; she had ascites, pleural effusion and a severely worsened lung condition. The patient was planned for an exploratory laparotomy and debulking surgery after preoperative optimisation. To prevent the re-expansion pulmonary oedema (RPO) following the excision of the tumour, a volume-restricted postoperative ventilation strategy was planned. Following enhanced recovery after surgery (ERAS) protocol and specific anaesthetic measures, we successfully managed the anaesthesia in a case of teratoma syndrome with a large abdominal tumour with successful recovery and early discharge from hospital.
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Dash et al. (2022) conducted a case report in Ovarian teratoma (growing teratoma syndrome) (n=1). Anaesthesia management (epidural with general anaesthesia) and volume-restricted postoperative ventilation was evaluated on Successful anaesthesia management and recovery without re-expansion pulmonary oedema. Anaesthesia management using a volume-restricted postoperative ventilation strategy and ERAS protocol successfully prevented re-expansion pulmonary oedema in a 15-year-old female undergoing excision of a massive ovarian teratoma.
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