Horache Kenza, Jidal Manal, Messaoud Ola, Omor Youssef, Latib Rachida, Amalik Sanae
Radiology Department, National Institute of Oncology, University of Medicine and pharmacy of Rabat, Rabat, Morocco.
Radiol Case Rep. 2024 Sep 24;19(12):6246-6249. doi: 10.1016/j.radcr.2024.08.162. eCollection 2024 Dec.
Thymoma, a rare tumor originating from thymic epithelial cells in the anterior mediastinum, presents various diagnostic and clinical challenges, particularly when exhibiting unusual invasive behaviors. We report a case involving a 66-year-old woman with progressive dyspnea and a dry cough, where a CT scan revealed a large, lobulated mass in the anterior mediastinum that had extended through the diaphragm into the abdominal cavity, infiltrating the pleura, spleen, and adjacent structures. Histopathological examination confirmed a type B2 thymoma, classified as T3N2M0 stage IV B. The case underscores the importance of early and accurate diagnosis, highlighting the need for a multidisciplinary approach involving radiologists, oncologists, and thoracic surgeons to manage such advanced thymoma cases. The unusual transdiaphragmatic extension into the peritoneum and spleen emphasizes the necessity of considering extensive local invasion in the staging and treatment planning of thymomas, which often necessitates a combination of chemotherapy and radiotherapy before potential surgical intervention.
胸腺瘤是一种起源于前纵隔胸腺上皮细胞的罕见肿瘤，带来了各种诊断和临床挑战，尤其是当表现出不寻常的侵袭行为时。我们报告一例病例，患者为一名66岁女性，有进行性呼吸困难和干咳症状，CT扫描显示前纵隔有一个大的分叶状肿块，已穿过膈肌延伸至腹腔，侵犯了胸膜、脾脏及相邻结构。组织病理学检查确诊为B2型胸腺瘤，分类为IV B期T3N2M0。该病例强调了早期准确诊断的重要性，突出了需要放射科医生、肿瘤内科医生和胸外科医生采用多学科方法来管理此类晚期胸腺瘤病例。不寻常的经膈肌延伸至腹膜和脾脏的情况强调了在胸腺瘤分期和治疗规划中考虑广泛局部侵犯的必要性，这通常需要在可能的手术干预之前联合化疗和放疗。
