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Thymoma vascular resection

Giulio Maurizi, Camilla Poggi, Antonio D'Andrilli, Camilla Vanni, Anna Maria Ciccone, Mohsen Ibrahim, Claudio Andreetti, Simone Maria Tierno, Federico Venuta, Erino Angelo Rendina
BACKGROUND: Advanced stage thymic tumours infiltrating Superior Vena Cava(SVC), when radically resectable, can be surgically treated by SVC prosthetic replacement within a multimodality therapeutic approach. We hereby present our series of patients undergoing SVC resection and prosthetic reconstruction for stage-III/IV thymic malignancies. METHODS: Between 1989 and 2015, 27 patients with thymic tumours(21 thymoma, 6 thymic carcinoma) infiltrating SVC underwent radical resection with SVC prosthetic replacement by a bovine pericardial conduit in 12 cases, a polytetrafluoroethylene(PTFE) conduit in 13, a porcine pericardial conduit in 1 and saphenous vein conduit in 1...
October 11, 2018: Annals of Thoracic Surgery
Naoya Kawakita, Kazuya Kondo, Hiroaki Toba, Akiko Yoneda, Hiromitsu Takizawa, Akira Tangoku
We present a case of type A thymoma with invasion of the left brachiocephalic vein and lung metastases. An 84-year-old man underwent extended thymectomy combined with left brachiocephalic vein reconstruction and resection of a lung metastasis. Histological examination showed vascular invasion by the tumor. The lung metastasis had high mitotic activity and slight nuclear enlargement, the so-called "atypical" features, but the main part of the primary tumor did not. However, the intravascular portion of the tumor had "atypical" histological features like the lung metastasis...
April 2018: General Thoracic and Cardiovascular Surgery
Nicola Passuello, Gioia Pozza, Stella Blandamura, Michele Valmasoni, Cosimo Sperti
A 71-year-old man presented with a thymic mass involving the superior vena cava. A mediastinoscopical biopsy initially suggested a diagnosis of type A thymoma. After neoadjuvant chemotherapy, the patient underwent en-bloc thymectomy and vascular resection for a pathology-confirmed type B3 thymoma involving the superior vena cava, the left brachiocephalic vein and the distal part of the right brachiocephalic vein. Adjuvant radiotherapy was administered. Two years after the primary surgery, abdominal computed tomography (CT) and whole body fluorodeoxyglucose (18-FDG) positron emission tomography (PET) scans showed a single hepatic lesion that was treated with wedge liver resection...
April 2017: Journal of International Medical Research
Yoko Karube, Satoru Kobayashi, Sumiko Maeda, Tetsu Sado, Hiromi Ishihama, Masayuki Chida
BACKGROUND: Thymic carcinoma (TC) is a rare type of malignant neoplasm that develops in the anterior mediastinum and associated with poor prognosis. Type B3 thymoma (B3) occasionally demonstrates malignant tumor characteristics, especially in the advanced stage. We investigated the expressions of tumor-related genes in resected TC and B3 specimens. METHODS: TC and B3 specimens resected from 1999 through 2012 were investigated. Tumor segments were collected from the specimens by micro-dissection to extract mRNA, then RT-PCR was performed according to Dannenberg's tumor profile method for semi-quantitation of tumor-related gene mRNA...
May 26, 2016: Journal of Cardiothoracic Surgery
Miao Zhang, Heng Wang, Xuefeng Pan, Wenbin Wu, Hui Zhang
The aim of the present study was to examine the feasibility and efficacy of thoracoscopic radical resection of large retrosternal thymoma using artificial pneumothorax. A retrospective analysis was performed on 19 patients with bulky thymoma who underwent thoracoscopic resection using artificial pneumothorax by CO2 insufflation. The operations were performed with unilateral or bilateral thoracic incisions via single lumen endotracheal intubation and two-lung ventilation. This approach provided excellent exposure of the thoracic cavity and reliable control of the neuro-vascular structures in the anterior mediastinum, which was of vital importance for the extended resection of malignant thymoma...
May 2016: Oncology Letters
Giuseppe Marulli, Jos Maessen, Franca Melfi, Thomas A Schmid, Marlies Keijzers, Olivia Fanucchi, Florian Augustin, Giovanni M Comacchio, Alfredo Mussi, Monique Hochstenbag, Federico Rea
BACKGROUND: Robotic thymectomy for early-stage thymomas has been recently suggested as a technically sound and safe approach. However, due to a lack of data on long term results, controversy still exists regarding its oncological efficacy. In this multi-institutional series collected from four European Centres with high volumes of robotic procedures, we evaluate the results after robot-assisted thoracoscopic thymectomy for thymoma. METHODS: Between 2002 and 2014, 134 patients (61 males and 73 females, median age 59 years) with a clinical diagnosis of thymoma were operated on using a left-sided (38%), right-sided (59...
January 2016: Annals of Cardiothoracic Surgery
Michael Ried, Reiner Neu, Berthold Schalke, Marietta von Süßkind-Schwendi, Zsolt Sziklavari, Hans-Stefan Hofmann
BACKGROUND: Radical surgical resection of advanced thymic tumors invading either the heart or great vessels facing towards the heart is uncommonly performed because of the potential morbidity and mortality. To achieve a complete tumor resection, the use of cardiolpulmonary bypass (CPB) support might be necessary. METHODS: Retrospective analysis of the results in six patients, who underwent radical tumor resection with CBP support. RESULTS: Mean age was 46 years (27 to 66 years) and five patients were male...
October 29, 2015: Journal of Cardiothoracic Surgery
Takahiro Saito, Takashi Makino, Yoshinobu Hata, Satoshi Koezuka, Hajime Otsuka, Kazutoshi Isobe, Naobumi Tochigi, Kazutoshi Shibuya, Sakae Homma, Akira Iyoda
The appropriate surgical approach for a large mediastinal tumor is controversial. Median sternotomy is the standard approach for thymomas. We herein report the case of a giant thymoma, 13 cm in diameter, surgically resected via anterolateral incision. Subsequent thymectomy was performed via thoracoscopy. The resected specimen was a WHO type AB thymoma, Masaoka stage I, without capsular invasion. The anterolateral incision was less invasive and more versatile in the present case, as the incision could be extended to a hemiclamshell or posterolateral incision depending on exposure and relationship to adjacent organs and vascular structures...
2015: Journal of Cardiothoracic Surgery
Yang Zhao, Haiquan Chen, Jianxin Shi, Limin Fan, Dingzhong Hu, Heng Zhao
OBJECTIVES: Chest computed tomography (CT) scanning has been widely utilized in thymoma identification and staging as well as in follow-up monitoring for recurrence. However, the relationship between some CT imaging features and pathological types, clinical stage, completeness of resection, or prognosis in thymoma has not been well explored. METHODS: We retrospectively reviewed preoperative CT imaging for 238 thymoma patients, who had undergone thymectomy from October 2007 to December 2011...
November 2015: European Journal of Cardio-thoracic Surgery
Yoshimasa Inoue, Shoji Sakai, Teruhiro Aoki
Downhill oesophageal varices (DEV) may occur as a rare complication of superior vena cava (SVC) obstruction. DEV are usually associated with SVC obstruction caused by systemic vasculitis or mediastinal tumours. In this report, we describe a very rare case of DEV resulting from SVC graft occlusion after resection of a thymoma. A 66-year old man with an invasive thymoma was treated by radical resection and bypass grafting from the right brachiocephalic vein to the right atrium. Occlusion of the SVC graft was diagnosed postoperatively; however, the patient could be managed conservatively...
September 2013: Interactive Cardiovascular and Thoracic Surgery
Keidai Ishikawa, Tatsuya Kato, Masato Aragaki, Toshiro Ohbuchi, Sachiko Kimura, Yoshiro Matsui, Mitsuhito Kaji
A rare case of Castleman's disease with myasthenia gravis is reported. A 55-year-old woman with bilateral ptosis, speech impairment, and severe dyspnea had been previously diagnosed with myasthenia gravis. Computed tomography showed a 5 cm × 3 cm paratracheal mass in the mediastinum, thought to be an ectopic thymoma. Two days after surgical resection, the patient suddenly developed dyspnea. Postoperative myasthenic crisis was diagnosed, and plasmapheresis was performed. Her general condition improved, and her subsequent course was uneventful...
2014: Annals of Thoracic and Cardiovascular Surgery
Kotaro Murakami, Taichi Kotani, Chiaki Ito, Ayako Haga, Yuji Kunitoku, Yoichiro Sakata, Yoshikazu Haratake
We report a case of a patient with two previous histories of resection of thymoma using median sternotomy and repair for an ascending aortic pseudoaneurysm using median thoracotomy undergoing endovascular aortic repair of the recurrence of pseudoaneurysm in the same site. Due to severe adhesion and calcification in the tissue after two histories of thoracotomy, we expected it impossible to repair the pseudoaneurysm with open thracotomy. We concluded that endovascular aortic repair was the best way for the case...
February 2013: Masui. the Japanese Journal of Anesthesiology
Alper Toker, Suat Erus, Sedat Ziyade, Berker Ozkan, Serhan Tanju
BACKGROUND: The objectives of this study were to evaluate the feasibility of video-assisted thoracoscopic (VATS) thymoma resection and to analyze the factors contributing to a successful perioperative period. METHODS: Fifty-one patients with thymoma underwent VATS with the aim of thymoma resection. Four patients underwent minithoracotomy [due to technical difficulties, including small chest cavity, high body mass index (BMI), and disintegration of the capsule] and three patients underwent sternotomy (due to invasion of major vascular structures)...
May 2013: Surgical Endoscopy
Giuseppe Marulli, Federico Rea, Franca Melfi, Thomas A Schmid, Mahmoud Ismail, Olivia Fanucchi, Florian Augustin, Marc Swierzy, Francesco Di Chiara, Alfredo Mussi, Jens C Rueckert
OBJECTIVE: Minimally invasive thymectomy for stage I to stage II thymoma has been suggested in recent years and considered technically feasible. However, because of the lack of data on long-term results, controversies still exist on surgical access indication. We sought to evaluate the results after robot-assisted thoracoscopic thymectomy in early-stage thymoma. METHODS: Data were collected from 4 European centers. Between 2002 and 2011, 79 patients (38 men and 41 women; median age, 57 years) with early-stage thymoma were operated by left-sided (82...
November 2012: Journal of Thoracic and Cardiovascular Surgery
Julissa Jurado, Jeffrey Javidfar, Alexis Newmark, Matt Lavelle, Matthew Bacchetta, Lyall Gorenstein, Frank D'Ovidio, Mark E Ginsburg, Joshua R Sonett
BACKGROUND: An open thymectomy is a morbid procedure. If a minimally invasive thymectomy is performed without compromising the tenets of thymic surgery, it has the potential for decreasing morbidity and may offer similar clinical and oncologic results. METHODS: This is an institutional review board-approved, retrospective study of a single center's experience with both open (transsternal) and minimally invasive (video-assisted thoracoscopic surgery) thymectomy. Survival estimates and statistical comparisons were calculated using standard software...
September 2012: Annals of Thoracic Surgery
Minoru Yamaki, Toshio Noriyuki, Masaki Hamamoto, Syuji Yonehara
Thymic carcinomas are rare neplasm. The standard treatment for advanced thymic carcinoma has not yet been established, and the prognosis is poor. We report 3 cases of thymic carcinoma involving major vessely. Case 1:The aortic arch and the innominate vein were involved. Case 2:The left brachiocephalic vein was involved. Case 3:Tumor invaded to superior vena cava. Complete resection of the tumor was possible with vascular reconstruction.
June 2012: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Michel Gonzalez, Thorsten Krueger, Jean Yannis Perentes, Oskar Matzinger, Solange Peters, Hans-Beat Ris
We report 4 patients with stage IVA thymic tumors who underwent extrapleural pneumonectomy and thymectomy with venous confluence resection using a temporary percutaneous venous jugular-femoral bypass technique. The superior vena cava was replaced in 2 patients, and the innominate vein was resected in 2 patients. Complete tumor resection was obtained in all patients. There was no 90-day postoperative mortality. One patient died at 6 months postoperatively of an unrelated cause, without recurrent disease, and 3 are alive and disease-free with a follow-up ranging from 19 to 80 months...
March 2011: Annals of Thoracic Surgery
Giuseppe Marulli, Marco Lucchi, Stefano Margaritora, Giuseppe Cardillo, Alfredo Mussi, Giacomo Cusumano, Francesco Carleo, Federico Rea
OBJECTIVE: Radical surgery is the cornerstone of treatment for thymic tumors, but a complete surgical resection in stage III is not always achievable; and recurrence of disease is not rare. We reviewed the results of four centers with large experience in multimodality treatment of stage III thymic tumors. METHODS: Between 1980 and 2009, 249 patients (137 males: 112 females; median age 50 years) with stage III thymic tumors underwent surgery. Myasthenia gravis (MG) was present in 110 (44...
March 2011: European Journal of Cardio-thoracic Surgery
K Arvind, D Roman, K Umashankkar, K J Pramod, K C Shiv, M Neeti
OBJECTIVE: To evaluate the safety, feasibility, and outcome following radical excision of thymoma with resection and reconstruction of invaded mediastinal vessels. STUDY DESIGN: A retrospective study. PATIENTS AND METHODS: Six patients with thymoma invading the superior vena cava (SVC) and/or the brachiocephalic veins (BCVs) were reviewed in this study. All the patients underwent radical excision of the tumor along with invaded mediastinal vessels followed by vessel reconstruction or repair...
October 2010: Indian Journal of Cancer
George Ronald Soncini da Rosa, Ney Takizawa, Douglas Schimidt, Mitur Sugita
We report on a case of a 57 years-old white male, patient, who presented superior vena cava syndrome (SVC) for 3 months, derived from an invasive thymoma in the medium and anterior mediastinum, compromising intrinsic and extrinsic to the SVC. After evaluation by computed tomography and magnetic angioresonance of the thorax, the patient underwent radical resection of the thymoma--bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevant case of invasive thymoma causing the occlusion of SVC...
April 2010: Revista Brasileira de Cirurgia Cardiovascular
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