Diagnosed with a Teratoma Juliana Breathes Easier Thanks to Pediatric Surgery

June 05, 2018

Jeffrey and Diana’s 20 month old daughter Juliana had ongoing fevers, chest pain, and abdominal pain. “For several months, Juliana was vomiting, had difficulty breathing, and was lethargic with almost no energy,” Diana said. “Something was definitely wrong with her, but we had no idea what the problem was.”

After six months and more than half a dozen visits to their pediatrician, on May 10, the Kents brought Juliana to the Kenneth Anne Griffin Emergency Care Center at Lurie Children’s where they met with members of the emergency department and pediatric surgeon Rashmi Kabre, MD.

A chest x-ray and CT scan showed that Juliana had a mass about the size of a cantaloupe in the right side of her chest, consuming all the space in the area. It was so large that it caused her right lung to collapse, and was pushing her heart and airway to the left side. From these images, it was clear that Juliana would need urgent surgery.

“Based on the pre-operative imaging and lab work, we had a strong suspicion that the mass was a type of tumor called a teratoma,” Dr. Kabre said.

A teratoma is comprised of different types of cells that can develop to become hair, muscle, bone, teeth or any other type of tissue in the body. They are all bundled together into a single abnormal mass and grow in areas of the body where they do not belong. There are two types of teratomas: mature and immature. Mature teratomas can often be removed and not require further intervention. Immature teratomas need to be closely monitored for possible recurrence.

“Dr. Kabre was absolutely wonderful,” Diana said. “She spent several hours with us to ensure that we understood the process.” But there were still a lot of unknowns as Juliana headed into a five hour surgery.

Juliana recovered well from the thoracotomy, a surgery that involves an incision into the chest wall. When the pathology results were available a few days later, it was confirmed that Juliana had what Dr. Kabre had expected: a teratoma, which ended up being immature. The tumor was large and had been growing for quite a while, but fortunately, it was able to be completely excised.

“Recovery was tough,” Jeffrey said. “They had to break two of her ribs to remove it; she couldn’t roll over. We had to be careful how we picked her up. She’d wake up screaming and crying but couldn’t tell us what was wrong. It was hard to see her so miserable.”

But the tough recovery was well worth it.

“She did a complete 180,” Diana said. “She has more energy now. She’s completely different. She’s a new person. Even her teachers at preschool have noticed she participates more, she talks more and she’s more outgoing.”

“The best thing is how much happier she is,” Jeffrey added. “She’s always smiling.”

“Juliana is a tough kid, and we love seeing young children bounce back like she has. It’s why I love pediatric surgery as a specialty,” Dr. Kabre said. “And even though she’ll need close observation over the next couple of years, she has a lot of family support that will really help her recover.”

Today, Juliana is a joyful, healthy two year old. She will require close observation and repeat imaging for the next year or so, but otherwise is completely well with no other restrictions.

“Dr. Kabre saved her life,” Diana and Jeffrey agreed. “We will always be so grateful.”

The Division of Pediatric Surgery at Lurie Children’s treats children with traumatic injuries to complex malformations and everything in between and performs more pediatric operations with the most advanced techniques than any other pediatric hospital in the Chicago metropolitan area.