The “growing teratoma syndrome” in primary mediastinal nonseminomatous germ cell tumors: Criteria based on current practice  Kenneth A. Kesler, MD, Jay B. Patel, MD, Laura E. Kruter, MD, Thomas J. Birdas, MD, Karen M. Rieger, MD, Ikenna C. Okereke, MD, Lawrence H. Einhorn, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 144, Issue 2, Pages 438-443 (August 2012) DOI: 10.1016/j.jtcvs.2012.05.053 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Preoperative axial CT of patient 1 demonstrating a large heterogeneous anterior mediastinal mass with cardiac/great vessel displacement and compression. The left pleural space is also obliterated. A leftward clamshell approach provided adequate exposure to the anterior mediastinum and pleural space for surgical removal. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 438-443DOI: (10.1016/j.jtcvs.2012.05.053) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Preoperative coronal CT of patient 5 demonstrating a large heterogeneous anterior mediastinal mass with cardiac/great vessel displacement and compression. The left pleural space is also obliterated. Because of significant inferior extension, surgical removal required an initial sternotomy and sequential left thoracotomy. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 438-443DOI: (10.1016/j.jtcvs.2012.05.053) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions