Kohiyama R, Hoshino T, Miyata M, Yamaguchi A, Adachi H, Yamada S
Department of Respiratory Surgery, Jichi Omiya Medical Center, Omiya, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Jun;43(6):861-5.
A 45-year-old female, who suffered from Superior Vena Cava (SVC) syndrome, was diagnosed as invasive thymoma by means of trans-sternal aspiration cytology (TSAC). After preoperative radiotherapy and two courses of neoadjuvant chemotherapy, she underwent radical tumor resection combined with partial resection of both SVC and the right atrium followed by pericardial patch repair under the cardiopulmonary bypass. Complete resection is the most important procedure for the therapy of invasive thymoma, even if the tumor is in advanced stage invading to large vessels such as SVC. As far as our knowledges are concerned, complete resection of invasive thymoma combined with partial resection of the right atrium is very rare. Our case shows that partial resection of the right atrium is not risky operative procedure, if the invaded lesion of the right atrial wall is localized at the antero-lateral side to which the sinus node and the conducting system is not close. And we chose pericardial patch repair for the large defect of SVC. This patch repair was good method in this case because the blood flow through the Azygos vein was well maintained. We would also like to emphasize that TSAC is useful diagnostic procedure for the mediastinal mass lesion to which transcutaneous aspiration using the ultrasound or CT scan as a guide is impossible.
