Dong Yong-Qiang, Liang Jiang-Shui, Zhang Xiao-Ming, Zhu Shui-Bo, Xu Jia-Hang, Ji Tao, Yin Gui-Lin
Department of Cardio-Thoracic Surgery, Wuhan General Hospital of Guangzhou Military Command, Wuhan, Hubei 430070, China.
World J Surg Oncol. 2014 Jan 8;12:6. doi: 10.1186/1477-7819-12-6.
Although invasive thymoma commonly infiltrates neighbouring mediastinal structures, its extension into the superior vena cava (SVC) and consequent SVC occlusion are rare. In such cases, the urgent removal of the thymoma and radical resection of the infiltrated SVC representreasonable options, since induction therapy is time-consuming and useless for symptom resolution. A case of invasive thymoma extending into the SVC and right atrium (RA) with SVC syndrome is reported. The patient underwent a combined resection of the invasive tumor and SVC under cardiopulmonary bypass (CPB), and the SVC and bilateral brachiocephalic vein (BCV) were reconstructed with an autologous pericardial 'Y' conduit. After 40 months of follow-up, the patient showed a patent graft and no tumor recurrence.
虽然侵袭性胸腺瘤通常会浸润邻近的纵隔结构,但其延伸至上腔静脉(SVC)并导致SVC闭塞的情况较为罕见。在这种情况下,紧急切除胸腺瘤并对浸润的SVC进行根治性切除是合理的选择,因为诱导治疗耗时且对症状缓解无效。本文报道了1例侵袭性胸腺瘤延伸至SVC和右心房(RA)并伴有SVC综合征的病例。该患者在体外循环(CPB)下接受了侵袭性肿瘤和SVC的联合切除,并使用自体心包“Y”形管道重建了SVC和双侧头臂静脉(BCV)。经过40个月的随访后,患者的移植血管通畅,无肿瘤复发。