Unexpected vacation ending leads to rare tumor discovery

Kelly and Jered Iverson of Grand Meadow, Minnesota, had planned a perfect Hawaiian vacation for themselves and their daughters, Isabelle (Izzy) and Emmy. They enjoyed seven days on Maui, where they went whale watching, attended a luau, drove the Road to Hana and spent hours on the beach.

"Izzy is a great traveler," says Jered of his 11-year-old daughter, who was born with a developmental delay. "She likes to see all the sights and loves the beach."

Blood tests showed her white blood count was elevated, so there was concern the pain was caused by appendicitis.

Izzy underwent a CT scan of her abdomen, which ruled out appendicitis but revealed a shocking surprise. She had a significant mass near her left lung. Its presence was staggering, but so was its composition. While additional tests would be necessary, the care team believed the mass was a teratoma.

Teratomas are rare, germ-cell tumors that are usually benign and form during gestation. They’re made up of tissue from all different parts of the body. A classic teratoma will contain hair, skin, bone, and muscle and organ tissues.

Izzy needed surgical evaluation, so she was transferred to Mayo Clinic in Rochester.

Transfer to Mayo Clinic

While shaken, Jered and Kelly tried to remain optimistic for their daughter.

"We tried, but we were puddles — just a mess," says Kelly. "You want to remain strong for your children, but I remember sobbing in the hall."

Kelly's parents met them in Cannon Falls to provide comfort and support. They also took Emmy home so Jered and Kelly could focus on Izzy. She was transported to St. Marys Hospital by ambulance. Kelly rode along and Jered followed behind in the family's car.

The following day, Izzy had additional tests and another CT scan to confirm the location of the mass. She would need surgery the next day to remove it. Only after it was removed and examined under a microscope would her care team know 100% if it was benign or cancerous.

Surgery

Child life specialists kept Izzy busy with painting and other activities that afternoon and evening. The following day, Izzy was wheeled into an operating room. The surgeon performed the three-hour surgery to remove the fist-sized mass, which occupied about one-third of her chest. He confirmed it was a teratoma due to its composition.

Teratomas in the chest are exceedingly rare. Most of the time, they develop in the ovaries, testes or tailbone. In Izzy’s case, the teratoma was slightly attached to the pericardium sack in the middle of the chest, but most of it was sitting right in the center of the chest and pushing the lungs to the side. It was in the thoracic cavity adjacent to the lungs but not invading the lungs.

Kelly and Jered got to see a photo of the teratoma after surgery, and the family nicknamed it "Izzy's Demogorgon" after a creature on the TV show "Stranger Things." Izzy remained in the hospital for two days after surgery. During this time, a pediatric ICU nurse, Marlee, made a lasting impression on Izzy.

"All of the staff was phenomenal. They came down to her level and made sure she was comfortable," says Kelly. "Now Izzy plays with this little doctor kit after school every day. She pretends to be Marlee and takes care of patients."

A few days after surgery, the pathology reports showed that Izzy's teratoma was benign and no additional care would be necessary. The family got more good news when they were told it shouldn't cause any lasting effects on Izzy's health or her lung capacity going into the future.

And recover she did. Izzy returned to school about a week after her surgery.

"We are just overwhelmed with the staff and how they treated her, but also how they treated us. We were really scared at first, but they had so much compassion," says Kelly. "I was just so impressed with how the teams work together. It was a really easy transition from Cannon Falls to Rochester. Everybody knew what was going on when they came into the room. They were all so great with her and us."

By Mayo Clinic Health System staff