Giant thymoma successfully resected via anterolateral thoracotomy: a case report

Saito, Takahiro; Makino, Takashi; Hata, Yoshinobu; Koezuka, Satoshi; Otsuka, Hajime; Isobe, Kazutoshi; Tochigi, Naobumi; Shibuya, Kazutoshi; Homma, Sakae; Iyoda, Akira

doi:10.1186/s13019-015-0321-y

Cited by 12 publications

(8 citation statements)

References 13 publications

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“…Hemiclamshell approach is a practical approach for giant thymomas due to better access to upper thoracic cavity compared with anterolateral thoracotomy. However, some people still choose anterolateral thoracotomy as the first choice to giant thymoma since the incision of this approach can be extended to either a posterolateral approach or a hemiclamshell approach (12). In our case, we also took anterolateral thoracotomy as first choice and extended the incision to hemiclamshell approach when the upper pole of tumor was difficult to expose.…”

Section: Discussionmentioning

confidence: 93%

“…Usually Median sternotomy was performed when tumor with normal size had invaded into the innominate vein (9), but was not suitable to the giant thymoma due to the bad access to the hilum or posterior thorax. Giant thymomas were resected through anterolateral thoracotomy in three studies (10)(11)(12). Hemiclamshell approach is a practical approach for giant thymomas due to better access to upper thoracic cavity compared with anterolateral thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

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Giant thymoma successfully resected via hemiclamshell thoracotomy: a case report

Zhao

Fang

2016

J. Thorac. Dis.

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Thymoma is an epithelial neoplasm of the thymus. It commonly lies in the anterior mediastinum and represents 20-30% of mediastinal tumours in adults. In this report we present a case of giant thymoma locating in the anterior-inferior mediastinum. A 46-year-old male came to our institute with slight pectoralgia and dyspnea. Chest CT shows a giant tumor measuring 19 cm × 16 cm × 15 cm in the left thoracic cavity.After careful examination, we performed surgery. At surgery, we found the tumor was adherent to left upper lobe of the lung, mediastinal pleura, and parietal pleural. The tumor was completely resected with combined resection of part left upper lobe of lung. The weight of the tumor was 2,135 g. Pathological diagnosis indicated a type AB thymoma according to the World Health Organization classification and a diagnosis of Masaoka stage IIB was made.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Giant thymoma successfully resected via hemiclamshell thoracotomy: a case report

Zhao

Fang

2016

J. Thorac. Dis.

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“…Although a median sternotomy is the gold standard for access to the mediastinum, that approach does not provide an adequate view for accessing the upper and lower chest cavity or deeper inside, and the optimal surgical approach for advanced thymic malignancy cases remains a point of discussion (8). The HCS approach has been shown to provide excellent exposure of tumor-infiltrated organs (9,10). At our institution, we use such a technique for patients with thymic malignancy who require a lobectomy because of suspected hilar vessel invasion.…”

Section: Discussionmentioning

confidence: 99%

Surgical resection for advanced thymic malignancy with pulmonary hilar invasion using hemi-clamshell approach

et al. 2018

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Background: The hemi-clamshell (HCS) approach provides a wide anterior view of the mediastinum as well as outstanding exposure of the pulmonary hilum. Here, we evaluated the utility and outcomes of this approach in cases of advanced thymic malignancy with hilar invasion. Methods: We performed a retrospective analysis of 14 patients with thymic epithelial malignancy surgically resected with an HCS approach. All required lung resection because of suspected pulmonary hilar vessel invasion. Results: Histological findings showed that 8 patients had a thymoma and 6 a thymic carcinoma. Thirteen patients underwent lung resection, a lobectomy or bilobectomy in 8 and wedge resection in 5, while 1 had an exploratory thoracotomy. Seven patients with a thymoma underwent resection of disseminated lesions and 8 of 10 who underwent phrenic nerve resection received diaphragmatic plication through an HCS procedure. There were no postoperative mortalities. Macroscopic complete surgical resection was achieved in 13 cases. Conclusions: An HCS approach was helpful for lung resection performed for advanced thymic malignancy with hilar invasion by providing multiple access paths to the tumor and hilum, allowing for a sufficient surgical margin. Furthermore, it was useful for resection of disseminated lesions and diaphragmatic plication.

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“…A median sternotomy is suitable for patients with possible invasion of the innominate vein [ 7 , 8 ], but access to the hila or posterior thorax can be difficult for cases of giant thymomas. Three patients with giant thymoma underwent resection via the anterolateral approach, which allows extension of the incision to include a posterolateral or hemiclamshell approach [ 6 , 12 , 14 ]. Only one patient with giant thymoma underwent resection via a median sternotomy and anterolateral thoracotomy [ 3 ], which was the approach we used for our patient.…”

Section: Discussionmentioning

confidence: 99%

Giant thymoma successfully resected via median sternotomy and anterolateral thoracotomy: a case report

Azuma

Otsuka

Makino

et al. 2018

J Cardiothorac Surg

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BackgroundSome patients with thymoma present with a very large mass in the thoracic cavity. Although the most effective treatment for thymoma is surgical resection, it is difficult to perform because of the size of the tumor and the infiltration of tumor into the surrounding organs and vessels. We report a patient with a giant thymoma that was completely resected via a median sternotomy and left anterolateral thoracotomy.Case presentationA 63-year-old woman presented with a mass in the left thoracic cavity that was incidentally found on a chest X-ray. Chest computed tomography revealed a giant mass (16 × 10 cm) touching the chest wall and diaphragm and pressed against the heart and left upper pulmonary lobe. Complete resection was performed via a median sternotomy and left anterolateral thoracotomy. The tumor was histologically diagnosed as a WHO type B2 thymoma, Masaoka stage II.ConclusionsGiant thymomas tend to grow expansively without invasion into surrounding organs and vessels. Surgical resection that employs an adequate approach must be considered, regardless of the size of the tumor.

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Giant thymoma successfully resected via anterolateral thoracotomy: a case report

Cited by 12 publications

References 13 publications

Giant thymoma successfully resected via hemiclamshell thoracotomy: a case report

Giant thymoma successfully resected via hemiclamshell thoracotomy: a case report

Surgical resection for advanced thymic malignancy with pulmonary hilar invasion using hemi-clamshell approach

Giant thymoma successfully resected via median sternotomy and anterolateral thoracotomy: a case report

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