AB008. A case of thymic typical carcinoid successfully resected by robot-assisted thoracoscopic surgery
Abstract

AB008. A case of thymic typical carcinoid successfully resected by robot-assisted thoracoscopic surgery

Akira Ogihara, Motoka Omata, Hiroaki Shidei, Shota Mitsuboshi, Hiroe Aoshima, Tamami Isaka, Takako Matsumoto, Masato Kanzaki

Department of Thoracic Surgery, Tokyo Women’s Medical University, Tokyo, Japan

Correspondence to: Akira Ogihara, MD. Department of Thoracic Surgery, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. Email: ogihara.akira@twmu.ac.jp.

Background: Neuroendocrine neoplasms of the thymus are exceedingly rare tumors. We herein report a case of typical carcinoid of the thymus. The tumor was successfully resected by robot-assisted thoracoscopic surgery (RATS).

Case Description: A 77-year-old man presented with an anterior mediastinal mass on chest magnetic resonance imaging (MRI) during a medical check-up. He had no symptoms were observed and his laboratory data did not reveal any abnormal findings including tumor markers such as cancer antigen 125 (CA-125), alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (HCG-β), and soluble interleukin-2 receptor (sIL-2R). Plain chest computed tomography (CT) revealed an isolated, well-defined mediastinal mass measuring 32 mm in maximum diameter, without invasion of ascending aorta. Chest MRI revealed a well-defined mass with low signal intensity in T1-weighted images and inhomogeneous high signal intensity in T2-weighted images. Positron emission tomography/CT scan with F-18 fluorodeoxyglucose suggested that the mass was associated with increased standardized uptake (max =64.82). The differential diagnosis was thymic carcinoma, thymoma, and mediastinal malignant lymphoma. The RATS excision of the anterior mediastinal tumor was performed with two port incision, a 3-cm utility thoracotomy, and carbon dioxide (CO2) insufflation in the right semi-lateral decubitus position. A 3-cm skin incision was made at the fourth intercostal space (ICS) in the anterior axillary line, and a wound protector (Gel POINT Mini Advanced Access Platform, Applied Medical, Rancho Santa Margarita, CA, USA) was placed. Through the wound protector, an 8-mm port was placed in the anterior axillary line as the third arm. Two 8-mm assisted ports were inserted at the sixth ICS on the anterior side and seventh ICS on the anterior-axillary line as the first and second arms, respectively. The rigid 30° oblique viewing endoscope was used. CO2 was insufflated at a set pressure of 5 mmHg. The pericardial fat pad and thymus including the tumor was dissected off the pericardium and mediastinum. The tumor was measured 3.8 cm × 3.5 cm × 1.9 cm. The final histopathologic examination diagnosed the tumor as a thymic typical carcinoid. The postoperative course was uneventful. No adjuvant radiation therapy was administered after surgery, and no signs of recurrence were observed at 32 months of follow-up.

Conclusions: We experienced a case of thymic typical carcinoid successfully resected by RATS.

Keywords: Typical carcinoid; robot-assisted thoracoscopic surgery (RATS); case report

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://med.amegroups.com/article/view/10.21037/med-24-ab008/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee(s) and with the Helsinki Declaration (as revised in 2013). Written informed consent was obtained from the patient for the publication of this case report. A copy of the written consent is available for review by the editorial office of this journal.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/med-24-ab008
Cite this abstract as: Ogihara A, Omata M, Shidei H, Mitsuboshi S, Aoshima H, Isaka T, Matsumoto T, Kanzaki M. AB008. A case of thymic typical carcinoid successfully resected by robot-assisted thoracoscopic surgery. Mediastinum 2024;8:AB008.

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