Constrictive Pericarditis due to Thymic Cancer Developed 17 Years after Resection of Thymoma with Myasthenia Gravis / 日本心臓血管外科学会雑誌

<p>It is reported that myasthenia gravis (MG) with thymoma occupy 20% of all MG and extended thymectomy is recommended. After having operation, it is rare, but cases of recurrence of thymoma and, what is worse, thymic cancer from residual thymus tissue are reported. A 69-year-old man came to our hospital to have his dyspnea level examined. He had a past history of MG with thymoma and he had undergone extended thymectomy 17 years previously. Enhanced CT showed pericardial thickening and many tumors in the epicardium. Catheterization study showed dip and plateau pattern of left ventricular pressure. We therefore diagnosed constrictive pericarditis (CP). We performed pericardiectomy under cardiopulmonary bypass. He was discharged ambulatorily on postoperative day 24. Histological findings of the tumor and the pericardium showed that they were dissemination of thymic cancer. It was considered that thymic cancer caused CP and it was an extremely rare case. We think this is the first report to the best of our knowledge.</p>

A Case of Thymic Squamous Cell Carcinoma Misdiagnosed as a Thyroid Cancer / 대한이비인후과학회지

Thymic carcinoma is a rare tumor that develops in the anterosuperior mediastinum. The prognosis of thymic carcinoma is poor. It is often misdiagnosed as a thyroid tumor in the fine needle aspiration cytology because of its rarity and non-organotypic cytoarchitectural structure. We have experienced a case of thymic carcinoma that was misdiagnosed as a thyroid carcinoma in the clinical, radiologic and cytologic evaluation. The patient visited our department due to hoarseness. Neck and chest CT scan showed a huge mass, and we supposed a malignant thyroid tumor from lower pole of the thyroid, which extended toward the superior mediastinum. The fine needle aspiration cytologic diagnosis of the mass showed that it was anaplastic carcinoma of the thyroid. Total thyroidectomy including mass and selective neck dissection was performed. Postoperative pathologic diagnosis was squamous cell carcinoma of the thymus. So we report this case with a review of literature.

Unusual Presentation of Thymic Carcinoma: Hypertrophic Osteoarthropathy

Hypertrophic osteoarthropathy is characterized by clubbing and periosteal new bone formation along the shaft of the long bones of the extremities. Although various intrathoracic malignancies have been associated with the development of HOA, it has been extremely rare for HOA to occur in a patient with a thymic carcinoma. Recently, we experienced a 63-year-old woman diagnosed as a thymic carcinoma with hypertrophic osteoarthropathy. She had both digital clubbing and cortical thickening in her lower extremities identified radiologically. We herein describe this case with a review of the literature.