Chan Puiyee Sophia, Patel Akshay J, Lucchese Gianluca, Bille Andrea
Department of Thoracic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, England.
Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, B15 2TT, England.
J Cardiothorac Surg. 2025 Jan 7;20(1):40. doi: 10.1186/s13019-024-03318-1.
Thymomas and thymic carcinomas are rare anterior mediastinal tumours, accounting for 0.2-1.5% of all cancers. Surgical resection is key to treatment, though invasion of surrounding structures like great vessels can complicate this. This case report details the management of a type B3 thymoma (T4 N0 M0) in a 41-year-old male.
A 41-year-old male presented with myasthenic symptoms and was diagnosed with a large thymic mass involving the brachiocephalic vein and superior vena cava. After 4 cycles of neoadjuvant chemotherapy, partial resection was performed, followed by radiotherapy. Residual disease led to a second surgery, during which tumour resection and vascular reconstruction using cardiopulmonary bypass were successfully completed. Postoperative recovery was uneventful.
Complete resection, including re-resection, when necessary, is crucial for improved outcomes in thymoma patients. Even with great vessel invasion, aggressive surgery, coupled with chemotherapy and vascular reconstruction, can achieve good survival outcomes.
Multimodal management, including chemotherapy, complete resection, and vascular reconstruction, offers the best prognosis for invasive thymomas, even with great vessel involvement.
胸腺瘤和胸腺癌是罕见的前纵隔肿瘤，占所有癌症的0.2 - 1.5%。手术切除是治疗的关键，不过肿瘤侵犯大血管等周围结构会使手术复杂化。本病例报告详细介绍了一名41岁男性B3型胸腺瘤（T4 N0 M0）的治疗过程。
一名41岁男性出现肌无力症状，被诊断为巨大胸腺肿物，累及头臂静脉和上腔静脉。经过4个周期的新辅助化疗后，进行了部分切除，随后进行放疗。残留病灶导致再次手术，术中成功完成了肿瘤切除及使用体外循环的血管重建。术后恢复顺利。
对于胸腺瘤患者，必要时包括再次切除的完整切除对于改善预后至关重要。即使存在大血管侵犯，积极的手术联合化疗及血管重建仍可取得良好的生存结果。
多模式治疗，包括化疗、完整切除和血管重建，即使对于侵犯大血管的侵袭性胸腺瘤也能提供最佳预后。
