Surgical outcomes in mediastinal teratoma

Abstract

<bold>Introduction:</bold> Teratomas represent 10% of mediastinal tumors. They are mature in 80 to 88% of cases and represent the most common benign variant of embryonic origin tumors. They frequently pose diagnostic and therapeutic challenges. <bold>Methods:</bold> This is a retrospective study conducted in the Ariana’s thoracic surgery department between January 2000 and December 2023, focusing on 30 cases of mediastinal teratomas. <bold>Results:</bold> The average age was 30 years. There were 18 women and 12men. The discovery was most often made in the presence of chest pain in 15cases, dyspnea in 6 cases, dry cough in 5 cases, dysphagia in one case, and was incidental in 3 cases. Imaging showed a heterogeneous anterior mediastinal opacity with areas of variable solid, liquid, fatty, and calcified density. The diagnosis was suspected based on the radiological appearance and confirmed by the definitive pathological examination, which concluded a mature teratoma in 29 cases. The approach was a posterolateral thoracotomy in 16 cases, a lateral thoracotomy in 5 cases, a sternotomy in one case, a video-assisted thoracoscopic surgery in one case, and a mini-video-assisted approach in 7 cases. The procedure consisted of a tumor resection that was extended to the pericardium for one patient, associated with a thymectomy for 3 patients, a left upper lobectomy for one patient, and a wedge resection in one patient. Postoperative outcomes were complicated for 3 patients. <bold>Conclusion:</bold> The only curative treatment for mediastinal teratomas remains complete surgical excision. The pathological examination is crucial to confirm the diagnosis and to search for malignant elements that will guide the prognosis and any potential future treatment.