ETwo years old girl admitted with opacity in the right lung like a giant mass and opacity like a rib in this infiltration and minimal effusion in X-Ray. In an emergency thoracotomy due to respiratory distress and mediastinal shift; a giant encapsuled mass was seen in the right intrathorasic cavity; it was completely covering the right middle and lower hemithorax. The mass was penetrated and fixed into
the diaphragm approximately 10 cm in diameter.It had penetrated towards the abdomen. The mass was separated by blunt dissections from the surrounding pleural tissues and pericardium. At the same time with the right upper subcostal incision, the mass was mobilized from the liver and gerato fascia by the blunt dissection. One cm away from the penetrating edge of diaphragm it has been incised and the mass (with thoracal part, and abdominal part, and penetrated diaphragm) totally removed via abdominal incision through the diaphragmatic defect.
Remaining edges of the diaphragm closed primarily. The histopathological diagnosis was combined malignant germ cell tumor (yolc sac tumor and mature teratoma) and she has been followed up and treated by pediatric oncology clinic. Postoperative local recurrence or metastasis was not found three years later.