Nagai S, Okamura Y, Ishihama H, Chimoto M, Ikeda Y, Shimada K
Department of Cardiothoracic Surgery, Dokkyo University School of Medicine, Tochigi, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Aug;45(8):1116-21.
A 61-year-old woman with cough and sputum and right scapular pain was referred to our hospital with a suspected anterior mediastinal tumor by Chest X-rays and CT-scan. The tumor was diagnosed as thymic cancer cytologically by fine needle biopsy. At the the thoracotomy via median sternotomy, the tumor adhered to left brachial vein, superior vena cava and pericardium and it was dissected by maneuver. It was diagnosed as moderately differentiated epidermoid carcinoma by histology of the surgical specimen and involvement of the pericardium was histologically presumed. The patient received postoperative radiation therapy. A year after operation, the tumor recurred in the pericardial cavity. Inspite of resection of the recurred tumor and an anticancer chemotherapy, the patient died of cardiac failure due to the proliferated tumor around the heart. There are some reports that epidermoid carcinoma of the thymus may have different responses to radiation therapy according to histologic tumor differentiations. At resection of epidermoid carcinoma of thymus, therefore, intraoperative pathologic examination of the adhesive part of excised specimen and additional resection were essential to resect thymic cancer radically.
