Muscolino Giuseppe, Doria Orietta, Vercellio Gianni
Ospedale Humanitas Gavazzeni, Bergamo.
Chir Ital. 2005 Mar-Apr;57(2):173-6.
From 1987 to 2000 108 patients were operated on for thymic tumours. Two of these underwent replacement of the superior vena cava with polytetrafluoroethylene prostheses because the tumours invaded the superior vena cava. One of these was affected by myasthenia gravis, and was treated preoperatively with concurrent radio-chemotherapy and lymphocytopheresis. The other received preoperative chemotherapy and post-operative radio-chemotherapy because of minimal residual disease. The clinical courses of the two patients are reported here and we conclude that eradication of thymic malignancies is suitable even when superior vena cava replacement is required, and that neither antimyasthenic therapy nor adjuvant and/or neoadjuvant treatment interfere with aggressive surgical management or vice versa. Moreover, the long-term survival of one of these patients despite relapse of disease shows that extended surgery is indicated in these cases.
1987年至2000年间，108例胸腺肿瘤患者接受了手术治疗。其中2例因肿瘤侵犯上腔静脉，接受了聚四氟乙烯人工血管置换上腔静脉手术。其中1例患有重症肌无力，术前接受了同步放化疗和淋巴细胞清除术治疗。另1例因残留病灶极少，接受了术前化疗和术后放化疗。本文报告了这2例患者的临床病程，我们得出结论，即使需要进行上腔静脉置换，根除胸腺恶性肿瘤也是合适的，抗重症肌无力治疗以及辅助和/或新辅助治疗均不影响积极的手术治疗，反之亦然。此外，其中1例患者尽管疾病复发但仍长期存活，这表明在这些病例中应进行扩大手术。
