Ruptured thymoma causing a hemothorax: A case report

Hokka, Daisuke; Ogawa, Hiroyuki; Tane, Shinya; Tanaka, Yugo; Tauchi, Shunsuke; Maniwa, Yoshimasa

doi:10.3892/ol.2015.3476

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…We assumed that the internal pressure of the tumor had increased as it was sandwiched between the intermediate bronchus and the heart, and it then ruptured into the lungs, where the pressure was most easily released owing to tumor invasion of the lungs. Six cases of penetration of thymomas into the thorax have been reported to date [5–10]. These patients complained of chest pain and/or dyspnea, but none of them had hemoptysis, as in the present case (Table 1).…”

Section: Discussionsupporting

confidence: 60%

“…Among anterior mediastinal tumors, mediastinal teratomas are known to infiltrate into the thorax, as these tumors contain some pancreatic tissue, which secretes pancreatic enzymes and causes histolysis and consequent rupture [4]. In contrast, an invasive thymoma with intrathoracic rupture has rarely been reported [5–10], but has been suggested to be caused by ischemia of the tumor wall owing to rapid growth. To our knowledge, this is the first case of intrapulmonary and intrathoracic rupture of an invasive thymoma requiring emergency surgery.…”

Section: Discussionmentioning

confidence: 99%

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Lifesaving surgery for a ruptured invasive thymoma using the hemi-clamshell approach: a case report

et al. 2019

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Background Among anterior mediastinal tumors, a teratoma is known to rupture with growth, but there have been few previous reports about thymoma rupture. We here report a rare case of an invasive thymoma with intrapulmonary and intrathoracic rupture requiring emergency life-saving surgery. To our knowledge, this is the first such case in the literature. Case presentation A 56-year-old woman suddenly experienced right precordial pain and hemoptysis. Enhanced computed tomography revealed a large mediastinal tumor pressing against the pulmonary hilar vascularity, with extravasation of blood into the right lung. Tumor rupture into the lungs was suspected. Given the deterioration of her respiratory status and hemodynamics, thymomectomy with removal of the involved tissues was urgently performed using the hemi-clamshell approach and intrapericardial dissection, with veno-arterial extracorporeal membrane oxygenation on standby. She survived, and no recurrence has been noted for 2 years postoperatively. Conclusions A large thymoma can suddenly rupture into the thorax, similar to the rupture of a teratoma. Additionally, in cases with hemoptysis, an appropriate procedure should be selected to reach both the pulmonary hilum and thorax for complete resection, as hemoptysis might suggest tumor invasion into the lungs.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Lifesaving surgery for a ruptured invasive thymoma using the hemi-clamshell approach: a case report

et al. 2019

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“…According to previous case reports, most patients with ruptures thymoma experience sudden chest pain or dyspnea ( 4 , 5 ), accompanied by bleeding from the tumor and demonstrated a hemothorax. That was induced and required an emergency surgical resection ( 6 , 7 ).…”

Section: Discussionmentioning

confidence: 99%

Rupture of thymoma due to recurrent tumor hemorrhage: a case report

Uebayashi¹,

Ema²,

Oiwa³

et al. 2023

AME Case Rep

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Background Rupture of a thymoma is rare, and due to its rarity, the mechanism of rupture remains unclear. Here we report a case of a ruptured thymoma that ruptured due to an increase in the intratumoral pressure caused by recurrent hemorrhaging. Case Description A 70-year-old woman presented 2 days prior persistent right chest and shoulder pain. A chest computed tomography (CT) scan revealed the presence of a mass occupying the anterior mediastinum and a right pleural effusion. It was diagnosed as an anterior mediastinum tumor. The increase in the levels of inflammatory markers and tumor necrosis observed on CT were suggestive of infection. As the general status of the patient was stable and she initially received antibiotic medical therapy, an improvement in the inflammatory marker levels was observed with antibiotic therapy. A surgical resection was performed 10 days after admission. Median sternotomy revealed a tumor extending from the mediastinum to the right thoracic cavity. Since the adhesion was strong and tumor invasion was suspected, the tumor was completely resected by combining a partial resection of the right middle and lower lobes with the pericardium. Pathological examination revealed that the tumor was a type B2 thymoma with fibrosis, necrosis, hemosiderosis, and hemorrhaging, suggesting recurrent hemorrhaging within the tumor. Conclusions Based on the findings of our case, recurrent hemorrhaging within the tumor led to an increase in the intratumoral pressure and chronic inflammation and necrosis weakened the tumor wall. These changes contributed to the subsequent rupture.

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“…Pleural or pericardial effusions as well as spontaneous tumor rupture have been rarely observed (13,14).…”

Section: Clinical Findingsmentioning

confidence: 99%

Thymic tumours: a single center surgical experience and literature review on the current diagnosis and management of thymic malignancies

Minervini¹,

Boschetti²,

Gregor³

et al. 2021

Gland Surg

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Objective: This study aimed to provide an extensive overview of clinical and pathological findings along with various therapeutic options analyzing in addiction, retrospectively, the surgical outcomes of a single center cohort.Background: Thymic neoplasms are rare thoracic tumors which commonly are located in the anterior mediastinum and are associated with a wide spectrum of clinical presentations. They may run an indolent course or could present a very aggressive biologic progression with infiltration of mediastinal structures and presence of distant metastases. The pathogenesis of these tumors is so far not completely clear. Several treatment modalities in a multidisciplinary setting have to be considered in order to provide the best treatment for patients affected by thymic tumors. Methods:We conducted a retrospective cohort analysis of all patients who underwent surgery due to thymic tumor in a university hospital located in Switzerland (Bern University Hospital) and then we performed a narrative review of the English literature using PubMed, Embase, Cochrane Database of Systematic Reviews and Scopus.Conclusions: Minimally invasive techniques play an important role in the treatment of thymic tumors. A careful patients selection in a multidisciplinary setting is mandatory in order to offer the best treatment for patients affected by thymic tumors.

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Ruptured thymoma causing a hemothorax: A case report

Cited by 5 publications

References 13 publications

Lifesaving surgery for a ruptured invasive thymoma using the hemi-clamshell approach: a case report

Lifesaving surgery for a ruptured invasive thymoma using the hemi-clamshell approach: a case report

Rupture of thymoma due to recurrent tumor hemorrhage: a case report

Thymic tumours: a single center surgical experience and literature review on the current diagnosis and management of thymic malignancies

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