Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
J Cardiothorac Surg. 2020 Oct 7;15(1):305. doi: 10.1186/s13019-020-01354-1.
Although complete surgical resection of thymic carcinoma is a prognostic factor, extended surgery combined with a major blood vessel procedure remains controversial because of the increased risk of mortality. We report a case of Stage IVa thymic carcinoma successfully resected with a pneumonectomy along with aortic arch replacement after chemotherapy.
A 45-year-old male was diagnosed with thymic carcinoma invasion to the aortic arch and left pulmonary artery. Malignant pericardial effusion was also noted, though disappeared after chemotherapy, thus surgical options were considered. A radical resection procedure including left pneumonectomy, aortic arch replacement with total rerouting of the supra-arch vessels, and right pulmonary artery plication was performed. The postoperative course was uneventful and the patient has been disease-free for 3 years.
Extended salvage surgery might be a valuable option for advanced thymic carcinoma.
尽管完全手术切除胸腺癌是一个预后因素，但由于死亡率增加，扩展手术联合大血管手术仍存在争议。我们报告了一例成功接受化疗后行全肺切除术联合主动脉弓置换术切除 IVa 期胸腺癌的病例。
一名 45 岁男性被诊断为胸腺癌侵犯主动脉弓和左肺动脉。也有恶性心包积液，但经化疗后消失，因此考虑手术治疗。行根治性切除术，包括左全肺切除术、主动脉弓置换术，弓上血管全重新吻合，以及右肺动脉折叠术。术后过程顺利，患者无病生存 3 年。
对于晚期胸腺癌，扩展挽救性手术可能是一个有价值的选择。
