Extended Thymectomy via Thoracoscopy and Cervical Incision in a Child with Anterior Mediastinal Mixed Germ Cell Tumor and Paraneoplastic Precocious Puberty

To our knowledge, this case represents the 1st pediatric anterior mediastinal mixed germ cell tumor treated with thoracoscopic extended thymectomy combined with a cervical incision. The approach allowed safe and complete resection despite cranial displacement of the thymus, while avoiding sternotomy. Recognition of endocrine manifestations such as hCG-induced precocious puberty is essential for early diagnosis. This case demonstrates that minimally invasive extended thymectomy with cervical extension is feasible in children and may be applied to achieve radical resection of complex anterior mediastinal tumors.