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CC BY 4.0 · European J Pediatr Surg Rep. 2021; 09(01): e72-e75
DOI: 10.1055/s-0041-1735807
Case Report

Hemi-Clamshell Approach for Fetal Lung Interstitial Tumor Resection in a Neonate: A Case Report

Yasuhiro Kuroda
1   Department of Pediatric Surgery, Kobe Children's Hospital, Chuo-ku, Kobe, Japan
,
Hiroaki Fukuzawa
1   Department of Pediatric Surgery, Kobe Children's Hospital, Chuo-ku, Kobe, Japan
,
Insu Kawahara
1   Department of Pediatric Surgery, Kobe Children's Hospital, Chuo-ku, Kobe, Japan
,
Keiichi Morita
1   Department of Pediatric Surgery, Kobe Children's Hospital, Chuo-ku, Kobe, Japan
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Abstract

Fetal lung interstitial tumor (FLIT) is a rare primary lung mass in neonates. Classical incisions, such as posterolateral thoracotomy or median sternotomy, do not provide optimal exposure of the operative field for the resection of pediatric thoracic giant tumors. Herein, we report a rare case of a FLIT in a full-term male neonate, with complete resection achieved using a hemi-clamshell approach, which provided the required visualization of the operative field. The neonate was transferred to our hospital because of mild respiratory distress, which developed 18-hour after normal vaginal delivery. A mass in his right chest, without a midline shift, was observed on chest radiographs. Computed tomography showed a well-circumscribed solid anterior cervicothoracic mass, with a uniform density and no apparent cysts, diagnosed as a primary thoracic giant tumor. Once the patient was clinically stabilized, we proceeded with right upper lobectomy, using a hemi-clamshell approach, full sternotomy, and anterolateral thoracotomy, on postnatal day 22.

Histopathologic examination revealed an 8.5 × 6.5 × 4.0 cm solid mass within the right upper lobe, which was diagnosed as a FLIT. His postoperative recovery was uneventful. The patient was followed up for 1 year, with no complaints or symptoms and no postoperative shoulder dysfunction. Gross total resection of primary thoracic giant tumors can be accomplished in neonates with optimal exposure of the chest cavity using a hemi-clamshell approach.

Keywords

fetal lung interstitial tumor - hemi-clamshell approach - neonate tumors


Publication History

Received: 22 January 2021

Accepted: 05 June 2021

Article published online:
24 November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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