Barely 18 days old and a tumor attached to her heart, filling her chest. A neoplasm called thymic teratoma, which the surgeons of the Policlinico San Matteo in Pavia removed from the newborn in thoracoscopy. A “unique case”, report from the IRCCS, an intervention without equal in scientific literature. “An excellent result, fruit of multidisciplinarity and collaboration”, which managed to heal the little girl.
“The intervention carried out has exceptional characteristics in that other cases of thymic teratoma removed by thoracoscopic route in neonatal age are not described in the literature – says Giovanna Riccipetitoni, head of pediatric surgery at San Matteo, in previous experiences in the treatment of masses thymic in pediatric patients – The mass was isolated from the pericardium and from the great vessels taking care not to damage the vascular and nervous structures attached. The operation was perfectly successful with the recovery of the patient who was discharged from the neonatal intensive care unit (Tin, ed) in excellent health conditions “.
The mother of the child, suffering from gestational diabetes and maternal-fetal isoimmunization – reconstructs a note – is sent to the specialists of the San Matteo Obstetrics and Gynecology Structure for the pathology of pregnancy, and subjected to fetal ultrasound, fetal magnetic resonance and fetal echocardiography . It is the first examination to detect “a voluminous right paracardiac mass”, while the other investigations highlight the extracardiac site: mass “adhering to the pericardium and the great vessels”. Elements that allowed the groups of Riccipetitoni, Arsenio Spinillo (Obstetrics and Gynecology 1) and Stefano Ghirardello (Neonatology and Tin) to plan the treatment to be reserved for the baby once born.
The birth takes place naturally, the little girl is hospitalized in Tin and subjected to other tests. Postnatal investigations – continues the note – confirm the prenatal diagnosis of paracardiac mass starting from the thymus (lymphoepithelial organ located in the anterior mediastinum), and attributable to thymic teratoma occupying the mediastinum and part of the right hemithorax. The surgical intervention with the thoracoscopic technique is thus arranged.
Riccipetitoni in the operating room; Mirko Bertozzi, pediatric surgeon; Marta Gazzaneo, doctor in specialist training; Simonetta Mencherini, anesthetist; Valeria Bertolini and Rosella Mezzadra, instrumentalists; Michela Besutti, nurse; Monica Maniezzo and Cristina Marra, social health workers. After the surgery, the patient was followed up in intensive post-operative care by Ghirardello’s team, then discharged.