Nakagawa K, Yasumitsu T, Kotake Y, Iwasaki T, In K
Department of Surgery, Osaka Prefectural Habikino Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Oct;40(10):1955-61.
Three cases of thymic carcinoid were surgically treated in our hospital. All 3 cases belonged to stage IVb (Masaoka's classification) because of anterior lymph nodes metastasis. A 44-year-old male patient died of multiple metastasis of bone and liver in 94 months after the operation. A 45-year-old female patient who had undergone operation 4 years ago, was re-operated on for recurrent carcinoid tumor but complete resection of the tumor could not be performed because of the tumorous invasion to superior vena cava, pericardium and costal bone. After the operation she has been treated by radiotherapy and any re-growth of the tumor has never been detected for 1 year. Another 50-year-old male patient who had been operated and treated by chemo-radiotherapy for thymic carcinoid before 50 months was diagnosed as recurrent tumor at left interpectoral lymph node. Radiotherapy is now preparing for this patient. 160 cases of thymic carcinoid reports in Japan were reviewed. 37 cases were stage IVb and 36 cases had supraclavicular or mediastinal lymph nodes metastasis. Those cases which had been underwent complete resection followed by radiotherapy seemed to have better prognosis. We conclude that patients of thymic carcinoid should be treated with complete resection including supraclavicular and mediastinal lymph nodes dissection, followed by radiotherapy.
我院手术治疗了3例胸腺类癌。所有3例均因前纵隔淋巴结转移而属于IVb期(马萨oka分类)。1例44岁男性患者术后94个月死于骨和肝多发转移。1例45岁女性患者4年前接受手术,因类癌肿瘤复发再次手术,但由于肿瘤侵犯上腔静脉、心包和肋骨,无法完整切除肿瘤。术后她接受了放疗,1年内未发现肿瘤复发。另1例50岁男性患者50个月前接受胸腺类癌手术及放化疗,现诊断为左胸肌间淋巴结复发肿瘤,目前正在为该患者准备放疗。回顾了日本160例胸腺类癌报告。37例为IVb期,36例有锁骨上或纵隔淋巴结转移。那些接受完整切除并随后放疗的病例似乎预后较好。我们得出结论,胸腺类癌患者应接受包括锁骨上和纵隔淋巴结清扫在内的完整切除,随后进行放疗。