Jinno T, Yamane M, Tago M, Nakagawa J, Ishiai S
Department of Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Kyobu Geka. 1997 Jun;50(6):515-9.
Carcinoid tumor of the thymus is a rare tumor and discovered not infrequently at advanced stage. A 56-year-old male was admitted to our hospital with severe chest pain. Chest X-ray film and CT scan, revealed a tumor mass in the anterior mediastinum. The patient underwent extended thymectomy including tumor completely through median sternotomy in combination with partial resection of pericardium, mediastinal pleura and left upper lobectomy using internal mammary artery (IMA) retractor. The microscopic findings of the tumor revealed carcinoid Invasion to pericardium and lung was found microscopically. After the operation he has been treated by radiotherapy and any regrowth of the tumor has never been detected for 32 months. This case who had been undergone complete resection using IMA retractor followed by radiotherapy seemed to have better prognosis. Accordingly, extended thymectomy including tumor should be carried out for thymic carcinoid, and the IMA retractor is useful for complete surgical resection through median sternotomy.
胸腺类癌是一种罕见肿瘤,常在晚期才被发现。一名56岁男性因严重胸痛入住我院。胸部X光片和CT扫描显示前纵隔有一肿瘤肿块。患者通过正中胸骨切开术接受了扩大胸腺切除术,包括完整切除肿瘤,并联合使用胸廓内动脉(IMA)牵开器进行心包部分切除、纵隔胸膜部分切除和左上肺叶切除。肿瘤的显微镜检查结果显示为类癌,显微镜下发现肿瘤侵犯心包和肺。术后患者接受了放射治疗,32个月来未发现肿瘤复发。该病例使用IMA牵开器进行了完整切除并随后接受放射治疗,似乎预后较好。因此,对于胸腺类癌应进行包括肿瘤在内的扩大胸腺切除术,IMA牵开器有助于通过正中胸骨切开术进行完整的手术切除。