ABSTRACT
ABSTRACT Background: Thymolipoma is a rare benign tumour of the mediastinum, accounting for 2%-9% of all thymic tumours. Although many case reports have been published in the literature, few studies have analysed the clinical and radiological features and the surgical outcomes of this tumour. Objective: To evaluate the clinical and radiological features and the surgical outcomes of the patients with thymolipoma. Methods: We reviewed the records of the Pathology Department from the beginning of 2005 to the end of 2013. Results: We identified 11 patients with thymolipoma. There were eight male and three female patients. Their ages ranged from 27 to 72 years, with the mean age of 40 years. All patients described pulmonary or extrapulmonary symptoms. Two patients (18.2%) had myasthenia gravis. Chest X-ray was normal in four patients. Computed tomography of the thorax revealed a mass located in the anterior mediastinum in all patients. It showed fat attenuation in 4 of 11 patients (36.4%). Thymectomy was performed in all patients. The surgical approach was thoracotomy in five, sternotomy in four and video-assisted thoracic surgery in two patients. Thymolipomas ranged in size from 4 to 33 cm. One patient died 2 years after surgery. None of the remaining patients had evidence of recurrence on follow-up. Conclusion: Thymolipoma is a rare tumour of the thymus. It may be associated with myasthenia gravis. Surgical resection is the treatment of choice in the patients with thymolipoma. Complete surgical resection is the cure in most patients.
ABSTRACT
Las infecciones por hongos son una causa de morbilidad y mortalidad, lo que lleva a un incremento de la estancia hospitalaria y a un aumento de los costos en salud, en el período neonatal. Durante este período, los prematuros son los más afectados. Las especies Candida son la causa principal de infección fúngica. La mayoría son causadas por C. albicans, C. parapsilosis, C. glabrata y C. tropicalis, aunque otras especies han sido reportadas. Una de ellas, como un patógeno emergente, es K. ohmeri. Este organismo ha sido reportado como patógeno en el período neonatal, principalmente en prematuros. Los factores de riesgo asociados a infección fúngica son accesos venosos centrales, inmunosupresión, larga estancia hospitalaria, intubación endotraqueal y uso de antibióticos. Presentamos a un neonato con una masa mediastinal, quien requirió múltiples intervenciones, como pericardiocentesis, catéter central, ventilación mecánica y antibióticos. Durante su evolución, presentó infección por K. ohmeri. Fue tratado con anfotericina B, con evolución clínica satisfactoria.
Invasive fungal infections are a considerable cause of morbidity, mortality, increased hospital stay durations, and high health care costs, during neonatal period. In this period, the premature infants are the most affected. Candida species are the leading cause of invasive fungal infections. The majority of neonatal Candida infections are caused by C. albicans, C. parapsilosis, C. glabrata and C. tropicalis, although other fungus species are being reported. One such emerging pathogen is K. ohmeri. This organism has been reported as a pathogen in the neonatal period, principally in premature infants. The risk factors associated with fungal infection are central line, immunosuppression, prolonged hospital stay, endotracheal intubation and exposure to antibiotics. We present a term baby with a mediastinal mass, who required several procedures, as pericardiocentesis, central catheters, mechanical ventilation, antibiotics. During his evolution, he presented infection by K. ohmeri. The baby was treated with amphotericin B, with satisfactory clinical course.