Robotic-assisted excision of anterior mediastinal mass

Subject: A 25-year-old patient presented with an incidentally discovered 6 cm anterior mediastinal mass.

Diagnosis: Imaging and percutaneous CT-guided biopsy were consistent with a cystic lesion. Differential diagnosis included thymic cyst, pericardial cyst, foregut congenital cyst, teratoma, and less likely, a cystic low-grade malignancy. Patient was offered radiographic surveillance, but wanted definitive diagnosis and therapy. She was offered minimally invasive resection of this cystic anterior mediastinal mass.

Treatment: Thoracic surgeon Paul Koh, MD, at Oregon Heart & Vascular Institute used the da Vinci™ Si Surgical System at Sacred Heart Medical Center at RiverBend to perform the minimally invasive procedure. Through one 12 mm incision and two 8 mm incisions in the right side of the chest, the mass was mobilized from the underlying pericardium and completely excised, along with the right lower pole of the thymus from which it arose. The phrenic nerve was carefully preserved, facilitated by the three-dimensional 10x magnified view provided by the da Vinci™ system.

Outcome: The patient was discharged the next day. The final pathologic diagnosis revealed a benign thymic cyst, with no evidence of atypia. She has had an uneventful recovery and has resumed all of her normal activities, including full-time employment as a barista.