Savu Cornel, Melinte Alexandru, Gibu Alexandru, Hallabrin Ionut, Zafiu Alexandru, Tudor Vasilica-Adrian, Diaconu Camelia, Gherghiceanu Florentina, Furtunescu Florentina, Radavoi Daniel, Balescu Irina, Bacalbasa Nicolae
Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumology, Bucharest, Romania.
Department of Thoracic Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Cancer Diagn Progn. 2021 Jul 3;1(4):363-370. doi: 10.21873/cdp.10048. eCollection 2021 Sep-Oct.
BACKGROUND/AIM: Thymomas are a rare type of mediastinal tumors with a slow growth rate. Because of this, they are well tolerated and patients usually present with large masses, which can extend in either of the thoracic cavities. The surgical approach for such tumors is dictated by the size and localization of the mass.
We present the case of a patient with a large thymoma, resected through surgery performed by left antero-lateral thoracotomy. The patient presented in our clinic with a persistent cough, dyspnea, chest pain and tightness. Standard thoracic X-ray revealed a bilateral increase in size of the mediastinal shadow, mainly on the left side, with well-defined margins and subcostal intensity. A thoracic computed tomography (CT) scan discovered a tumoral mass within the antero-superior mediastinum, with compression of the mediastinal organs; presentation being suggestive for a thymoma. Surgery was performed, removing a 15/13/10 cm thymoma with a weight of 1126 g. Pathological examination as well as immunohistochemistry confirmed our diagnosis of type AB thymoma, stage I Masaoka-Koga.
In conclusion, surgical treatment remains the main therapeutic option in thymomas, but it is often difficult to perform due to tumor size and local invasion. However, even in large thymomas of stages I and II, surgery can be performed using an antero-lateral thoracotomy.
背景/目的:胸腺瘤是一种罕见的纵隔肿瘤,生长缓慢。因此,它们耐受性良好,患者通常表现为巨大肿块,可向任一胸腔扩展。此类肿瘤的手术方式取决于肿块的大小和位置。
我们报告一例巨大胸腺瘤患者,通过左前外侧开胸手术切除。该患者因持续咳嗽、呼吸困难、胸痛和胸闷前来我院就诊。标准胸部X线显示纵隔阴影双侧增大,主要在左侧,边缘清晰,肋下密度增强。胸部计算机断层扫描(CT)发现前上纵隔有一个肿瘤肿块,压迫纵隔器官;表现提示为胸腺瘤。进行了手术,切除了一个15/13/10厘米的胸腺瘤,重1126克。病理检查及免疫组化证实我们诊断为AB型胸腺瘤,Masaoka-Koga I期。
总之,手术治疗仍然是胸腺瘤的主要治疗选择,但由于肿瘤大小和局部侵犯,手术往往难以进行。然而,即使是I期和II期的巨大胸腺瘤,也可采用前外侧开胸手术。