AB054. A case report of thymoma resection with invasion into the superior vena cava
Abstract

AB054. A case report of thymoma resection with invasion into the superior vena cava

Yuwen Bai1, Yanzhong Xin1, Chengyuan Fang1,2, Luquan Zhang1, Jianqun Ma1

1Department of Esophageal and Mediastinum, Harbin Medical University Cancer Hospital, Harbin, China; 2Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA

Correspondence to: Jianqun Ma, MD. Department of Esophageal and Mediastinum, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin 150001, China. Email: jianqunma@hrbmu.edu.cn.

Background: Thymomas, rare neoplasms of the mediastinum, present substantial surgical challenges when invading the superior vena cava (SVC). This report details a successful surgical resection of a thymoma with SVC involvement.

Case Description: A 50-year-old male, asymptomatic at presentation, discovered a mass during self-examination. Computed tomography (CT) imaging revealed an anterior mediastinal mass consistent with a thymoma, with subsequent imaging confirming SVC invasion. The patient had no relevant medical history. Following preoperative neoadjuvant radiotherapy, the tumor demonstrated partial control, though partial remission (PR) was not achieved. After comprehensive multidisciplinary team consultation, surgical intervention was planned. The patient was positioned supine, and a median sternotomy was performed. The tumor, lacking clear demarcation, involved the bilateral pleura, pericardium, left and right brachiocephalic veins, SVC, and right upper lung. An en-bloc resection of the tumor, invaded pericardium, pleura, and right upper lung lobe was conducted. Bilateral brachiocephalic veins and the SVC were ligated, with invaded sections excised from the vessel walls. Adequate blood return was preserved to prevent postoperative reflux obstruction while ensuring negative tumor margins. The operation lasted 175 minutes, with an intraoperative blood loss of 600 mL. Postoperatively, the patient was admitted to the intensive care unit (ICU) for 48 hours and then transferred to the general ward. No significant postoperative complications were observed. The chest drainage tube was removed on postoperative day 3, and the patient ambulated independently on day 4. Postoperative pathological examination revealed a 6 cm tumor, consistent with a type B3 thymoma.

Conclusions: This case illustrates that, despite the inherent challenges, surgical resection of a thymoma invading the SVC can be successfully achieved through meticulous preoperative planning and precise intraoperative management. It underscores the significance of a multidisciplinary approach and the advances in surgical techniques in managing complex thymomas.

Keywords: Case report; thymoma; superior vena cava invasion (SVC invasion)

Acknowledgments

Funding: This work was supported by Haiyan Foundation of Harbin Medical University Cancer Hospital (No. JJQN2022-13).

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-ab054/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-ab054
Cite this abstract as: Bai Y, Xin Y, Fang C, Zhang L, Ma J. AB054. A case report of thymoma resection with invasion into the superior vena cava. Mediastinum 2024;8:AB054.

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