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Hemiclamshell Resection of a Ruptured Mediastinal Teratoma Exhibiting Pancreatic Differentiation
Yuri Enomoto1, Yoshio Nakano1, Hiroyuki Fukuda2
1Department of Respiratory Medicine Sakai City Medical Center Sakai Japan.
Respirology Case Reports
|September 22, 2025
Summary
Mediastinal teratomas with pancreatic differentiation are rare. This case highlights a teratoma misdiagnosed as ectopic pancreas, emphasizing surgical approach for complete resection.
Area of Science:
- Thoracic Surgery
- Surgical Pathology
- Oncology
Background:
- Mediastinal teratomas with pancreatic differentiation are exceptionally rare.
- Ectopic pancreas in the mediastinum can present diagnostic challenges.
Purpose of the Study:
- To report a rare case of mediastinal teratoma with pancreatic differentiation.
- To emphasize the importance of considering teratoma in the differential diagnosis of anterior mediastinal masses.
- To illustrate the utility of the hemiclamshell approach for complex resections.
Main Methods:
- Case presentation of a 36-year-old woman with anterior chest pain.
- Diagnostic imaging using computed tomography (CT) revealed a large anterior mediastinal mass.
- Surgical management involved radical excision via a hemiclamshell incision.
Main Results:
- Histopathology confirmed a mediastinal teratoma with predominant pancreatic acinar tissue.
- The lesion was initially suspected to be ectopic pancreas but reclassified based on teratomatous components.
- The patient experienced an uneventful postoperative recovery.
Conclusions:
- Mediastinal teratoma should be included in the differential diagnosis of anterior mediastinal lesions.
- The hemiclamshell approach is effective for complete and atraumatic resection of complex mediastinal masses with adhesions.
