Chabchoub Ben Abdallah R, Maalej B, Abdelmoulla S, Bouraoui A, Gargouri L, Ben Hlima N, Mahfoudh A
Service de pédiatrie, urgences et réanimation pédiatriques, CHU Hédi Chaker, route El Ain Km 0.5, Sfax, Tunisie.
Arch Pediatr. 2011 Jul;18(7):745-9. doi: 10.1016/j.arcped.2011.03.023. Epub 2011 May 18.
Thymoma is an uncommon tumor of childhood. It is an anterior mediastinal tumor with few symptoms. The pleura is the most frequent metastatic site. Surgery is the treatment of choice and the most important prognostic factors are the stage at initial presentation and whether complete resection can be performed.
A 6-year-old girl with no pathological antecedent presented with a history of prolonged fever. Frontal chest radiography showed a large mediastinal soft tissue mass with sharp lateral and inferior margins. Computed tomography showed a large anterosuperior and medium mediastinal mass measuring 83 mm × 70 mm, associated with variable size mediastinal adenopathy, suggesting the diagnosis of lymphoma. Histological examination of bone marrow biopsy found no haematological malignant diseases such as lymphoma. The histological examination of computed tomography (CT)-guided transthoracic biopsy demonstrated proliferation of polyclonal lymphocyte T cells, confirming the diagnosis of thymoma. The patient benefited from induction chemotherapy (cisplatin and VP16) followed by surgery with complete resection. The patient is doing well 24 months after resection and has no signs of recurrence; CT follow-up showed a stable size of residual thymus.
Thymoma is a benign tumor but the significant risk of recurrence warrants long follow-up.
胸腺瘤是一种儿童期罕见的肿瘤。它是一种前纵隔肿瘤，症状较少。胸膜是最常见的转移部位。手术是首选的治疗方法，最重要的预后因素是初次就诊时的分期以及能否进行完整切除。
一名6岁女童，无既往病史，有长期发热史。胸部正位X线片显示纵隔有一个大的软组织肿块，边缘清晰，位于外侧和下方。计算机断层扫描显示前上纵隔和中纵隔有一个83毫米×70毫米的大肿块，伴有大小不一的纵隔淋巴结肿大，提示淋巴瘤诊断。骨髓活检的组织学检查未发现淋巴瘤等血液系统恶性疾病。计算机断层扫描（CT）引导下经胸活检的组织学检查显示多克隆淋巴细胞T细胞增殖，确诊为胸腺瘤。患者接受诱导化疗（顺铂和VP16），随后进行手术并完整切除。切除术后24个月患者情况良好，无复发迹象；CT随访显示残余胸腺大小稳定。
胸腺瘤是一种良性肿瘤，但复发风险较高，需要长期随访。
