Excision of a Giant Mediastinal Teratoma with Pericardial Repair—Case Report with Review of Literature

A BSTRACT Mediastinal teratomas, despite their rarity, make up the majority of germ cell tumors that develop in the mediastinum. We report a 19-year-old female presented with chest pain radiating to her back and dyspnea on exertion. A CT scan of the thorax showed a mass lesion with features suggestive of a teratoma. Patient underwent sternotomy with left anterolateral thoracotomy. A large mass in the left hemithorax was compressing major vessels, adherent to chest wall, pericardium and lung which required pericardiectomy and wedge resection of lung. Bovine pericardium patch, 7 × 7 cm, was used to cover the pericardiectomy defect. The en bloc resected mass, histopathologically suggestive of mature teratoma of the mediastinum. Patient had uneventful recovery postoperatively. Managing large intrathoracic tumors, especially when they are in close proximity to critical structures, requires significant experience and quick decision-making during surgery. Proper closure of the pericardial defect is vital for successful outcomes in such supra-major cases.