Uniportal video-assisted thoracoscopic surgery for complex mediastinal mature teratoma: A case report

BACKGROUND: Mediastinal mature teratoma is the most common histological type of primary extragonadal germ cell tumor. In this report, we describe a rare case of giant mature teratoma located primarily in the anterior mediastinum and causing partial atelectasis of the upper and middle lobes of the right lung, as well as extrinsic compression of the right atrium. CASE SUMMARY: A 31-year-old male with a giant mediastinal mature teratoma presented with progressive exertional dyspnea and chest pain for 1 mo. Computed tomography of the chest indicated the diagnosis of anterior mediastinal teratoma. The patient underwent right uniportal anterior approach video-assisted thoracoscopic surgery (VATS). En bloc resection of the giant teratoma, wedge resection of the upper and middle lobes of the right lung, resection of the thymus and partial excision of the pericardium were successfully performed. The pathological diagnosis revealed a mature cystic teratoma with foreign-body reaction that was closely related to the right lung, atrium dextrum, superior vena cava and ascending aorta. An atrophic thymic tissue was also discovered at the external teratoma surface. The patient was discharged on postoperative day 7. CONCLUSION: This is the first report of the use of uniportal VATS for complete resection of a teratoma in combination with wedge resection of the right upper and middle lung lobes and partial resection of the pericardium.