Thoracoscopic Resection of a Mediastinal Mature Cystic Teratoma in a Two-month-Old Infant: A Case Report and Literature Review.

Objective: Mediastinal teratomas are rare in the pediatric population and are even more infrequent in neonates and young infants. Early detection and appropriate surgical intervention are critical to avoid complications associated with airway compression. Minimally invasive thoracoscopic resection has emerged as a viable approach, though its application in infants remains technically challenging. Materials and Methods: We present the case of a two-month-old male infant who was referred with progressive respiratory distress. Imaging revealed a well-circumscribed middle mediastinal mass compressing the left main bronchus. Thoracoscopic resection was performed after multidisciplinary planning. Intraoperatively, a cystic teratoma was identified, and decompression of its contents facilitated excision. A small bronchial perforation was noted and successfully repaired thoracoscopically. Results: Histopathological analysis confirmed a mature cystic teratoma without malignant features. The postoperative course was uneventful, and follow-up imaging at four months showed no recurrence. This case demonstrates that thoracoscopic resection is a safe and effective option for managing mediastinal mature cystic teratomas in very young infants. Conclusion: This case contributes to the growing evidence supporting thoracoscopy as a preferred approach in selected pediatric mediastinal lesions. With meticulous planning, technical expertise, and postoperative care, minimally invasive surgery can provide excellent clinical and cosmetic outcomes.