Video-Assisted Thoracoscopic Surgery for a Cystic Seminoma of the Mediastinum Mong-Wei Lin, MD, Yih-Leong Chang, MD, Chen-Tu Wu, MD, Yung-Chie Lee, MD,

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Video-Assisted Thoracoscopic Surgery for a Cystic Seminoma of the Mediastinum Mong-Wei Lin, MD, Yih-Leong Chang, MD, Chen-Tu Wu, MD, Yung-Chie Lee, MD, PhD The Annals of Thoracic Surgery Volume 90, Issue 6, Pages 2041-2044 (December 2010) DOI: 10.1016/j.athoracsur.2010.04.096 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Chest roentgenogram shows a well-defined bulging tumor in the right anterior mediastinum. (B) Chest computed tomography shows a right anterior mediastinal mass located at the right heart border, with mild compression of the right ventricle. The tumor was 7.5 × 6.0 cm in size. The cyst wall was enhanced by contrast and was mildly calcified. No direct invasion of the lung parenchyma or mediastinal structure was noted. The Annals of Thoracic Surgery 2010 90, 2041-2044DOI: (10.1016/j.athoracsur.2010.04.096) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Under the thoracoscopic view, the tumor was well capsulated, well demarcated, and arose from the right side of the thymus and pericardial fat. No direct invasion or adhesion to lung parenchyma or pericardium was noted. (B) The cut surface of the tumor demonstrates the cystic structure and a heterogeneous lobulated component containing yellowish fluid. The Annals of Thoracic Surgery 2010 90, 2041-2044DOI: (10.1016/j.athoracsur.2010.04.096) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Photomicrograph demonstrates the border between the tumor and the cystic cavity. Microscopically, the tumor was composed of abundant glycogen-rich, round to polygonal, fairly uniform tumor cells with round to oval nuclei and one or more large central nucleoli (hematoxylin and eosin stain; original magnification ×100) (B) Immunohistochemical stain for C-kit demonstrates positivity in the cell membrane (original magnification ×200). The Annals of Thoracic Surgery 2010 90, 2041-2044DOI: (10.1016/j.athoracsur.2010.04.096) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions