Paranji Sreshta, Khurshid Aatif, Sharma Pritika, Vegunta Rathnamitreyee, Fanucchi Michael
Internal Medicine, Westchester Medical Center, Valhalla, USA.
Hematology/Oncology, Westchester Medical Center, Valhalla, USA.
Cureus. 2024 Jun 29;16(6):e63463. doi: 10.7759/cureus.63463. eCollection 2024 Jun.
Anterior mediastinal masses, including thymomas, can present with thoracic symptoms or paraneoplastic syndromes, especially in adults over 40. Diagnosis involves imaging and biopsy, and treatment includes surgical resection and chemotherapy, depending on the stage. A 31-year-old male, with a history of alcohol use disorder and a former smoker, presented with increasing heartburn, shortness of breath, left shoulder pain, and chest pain. Imaging revealed an anterior mediastinal mass with pleural thickening and a small effusion. A biopsy confirmed a B2-type thymoma. Initial treatment included cyclophosphamide, doxorubicin, and cisplatin, resulting in significant tumor reduction and pleural effusion resolution. The patient underwent planned surgical resection following neoadjuvant chemotherapy. This case highlights the complexity of advanced thymoma treatment and the effectiveness of neoadjuvant chemotherapy in reducing tumor burden, the associated effusions, and improving outcomes. Continuous follow-up and further studies are essential to optimize treatment protocols for advanced thymoma.
前纵隔肿块，包括胸腺瘤，可表现出胸部症状或副肿瘤综合征，尤其是在40岁以上的成年人中。诊断包括影像学检查和活检，治疗方法包括手术切除和化疗，具体取决于分期。一名31岁男性，有酒精使用障碍病史且曾吸烟，出现烧心加重、呼吸急促、左肩疼痛和胸痛症状。影像学检查显示前纵隔肿块伴胸膜增厚和少量胸腔积液。活检证实为B2型胸腺瘤。初始治疗包括环磷酰胺、阿霉素和顺铂，使肿瘤显著缩小且胸腔积液消退。患者在新辅助化疗后接受了计划性手术切除。该病例凸显了晚期胸腺瘤治疗的复杂性以及新辅助化疗在减轻肿瘤负荷、相关胸腔积液及改善预后方面的有效性。持续随访和进一步研究对于优化晚期胸腺瘤的治疗方案至关重要。
