Case report: rare giant volumetric formation of the chest in an 11-month-old child

Abstract

Background. Neoplasms of the chest in children remain an urgent problem, since they can have a long asymptomatic course, and large sizes risk posing a threat to life.Clinical case description. In the presented clinical case (0.4%) in a girl of 11 months against the background of acute respiratory failure, X-ray method revealed a total heterogeneous darkening of the left half of the chest. Spiral computed tomography (SCT) detailed the huge size and heterogeneous structure of the mass, dislocation of the mediastinum to the right, collapse of the left lung. Performed surgical treatment: open thoracotomy, adhesiolysis of adhesions, removal of education in the capsule. Thoracoscopic surgery had limitations due to the large size of the tumor. The histological picture, taking into account the immunophenotype, corresponded to a mature teratoma with low proliferative activity (5% Ki67) and belonged to the group of germ cell neoplasm’s.Conclusion. The presented clinical example demonstrates that the discovered rare primary mediastinal teratoma of gigantic size had a rapid growth, lack of clinical symptoms, and posed a threat to the life of an infant. SCT with contrast was the optimal method for visualizing a neoplasm in a child with respiratory failure. The gigantic size of the dermoid cyst, the adhesive process of its membranes, limits the possibilities of thoracoscopic treatment. Early diagnosis of chest formations requires high alertness of primary care pediatrician.