Surgery for Stage IVA Metastatic Thymoma Found Incidentally Post-COVID-19
British Journal of Surgery
; 109:vi56, 2022.
Article
in English
| EMBASE | ID: covidwho-2042556
ABSTRACT
Background:
Thymic epithelial tumours (TET) are rare thoracic cancers with reported annual incidence of 1.3-3.2 per million. TETs are histologically classified as thymomas or thymic carcinomas. Thymomas are slow-growing tumours that comprise the majority of lesions found in the anterior mediastinum. They can be associated with autoimmune disorders such as Myasthenia Gravis. Contrast CT is the standard for diagnosis. Surgery is treatment of choice depending on resectability of the tumour. The Masaoka-Koga staging system is correlated with overall survival and is utilised post-surgical resection to guide adjuvant treatment. Case Presentation A 50-year-old male presented with cough, shortness of breath, myalgia, sore throat, and reduced sense of smell that was diagnosed as COVID-19. CT chest and abdomen showed a large heterogeneous mediastinal mass (11cm) invading the innominate vein and left upper lobe with two left pleural deposits, and diaphragmatic disease. CT biopsy confirmed thymoma. MDT recommended surgery due to patient age and resectability of tumour with post-operative chemotherapy. The sites of disease necessitated a left thoracotomy and median sternotomy. The pleural and diaphragmatic deposits were resected, followed by left upper lobe anatomical dissection enbloc with invaded pericardium, phrenic and vagus nerve, followed by median sternotomy to resect the thymic mass along with the innominate vein. Final staging was stage IVA thymoma (B2 and B3) (T3N0M1aR0). A CT scan at 1 year showed no recurrence despite patient declining adjuvant chemotherapy.Conclusion:
Surgical resection is a viable treatment option for patients with stage IVA thymoma who present with resectable primary and metastatic disease.
adjuvant; abdomen; adjuvant chemotherapy; adult; autoimmune disease; brachiocephalic vein; cancer adjuvant therapy; cancer patient; cancer recurrence; cancer staging; cancer surgery; cancer survival; case report; clinical article; conference abstract; coronavirus disease 2019; coughing; dissection; dyspnea; excision; female; guiding device; human; human cell; male; median sternotomy; mediastinum mass; metastasis; middle aged; myalgia; myasthenia gravis; odor; overall survival; pericardium; sore throat; surgery; thoracotomy; thymoma; vagus nerve; x-ray computed tomography
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Long Covid
Language:
English
Journal:
British Journal of Surgery
Year:
2022
Document Type:
Article
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