Sato S, Hirano J, Itsubo K, Mashiko K, Nakano M, Kurosawa H
Department of Surgery, Daisan Hospital, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Jul;44(7):998-1002.
A 43-year-old woman with a complaint of facial swelling was admitted to our hospital. A chest roentgenogram revealed a mass in the mediastinum. Chest CT and MRI demonstrated a mass in the anterior mediastinum protruding into the superior vena cava (SVC) and right atrium. A diagnosis of thymoma was made by needle biopsy. The patient underwent surgery without preoperative treatment. The tumor extended across the capsule of hte thymic gland and a polypoid growth of tumor reached the right atrium through the lumen of the thymic and left brachiocephalic veins and the SVC. No direct infiltration into the SVC or pericardial cavity was observed. Under cardiopulmonary bypass, the tumor was resected with the left brachiocephalic vein, SVC, and the upper third of the right atrium. The SVC was reconstructed using an EPTFE graft. Histopathologic examination demonstrated a predominantly epithelial cell thymoma. Adjuvant chemotherapy was performed, and no recurrence has been recognized for 3 years postoperatively.
一名43岁主诉面部肿胀的女性入住我院。胸部X线片显示纵隔有一肿块。胸部CT和MRI显示前纵隔有一肿块突入上腔静脉（SVC）和右心房。经针吸活检诊断为胸腺瘤。患者未接受术前治疗即接受了手术。肿瘤侵犯胸腺被膜，肿瘤呈息肉样生长，经胸腺和左头臂静脉及上腔静脉管腔延伸至右心房。未观察到直接侵犯上腔静脉或心包腔。在体外循环下，切除肿瘤及左头臂静脉、上腔静脉和右心房上三分之一。用上腔静脉补片重建上腔静脉。组织病理学检查显示主要为上皮细胞型胸腺瘤。进行了辅助化疗，术后3年未发现复发。
