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Vol.64 No.3 contents | Japanese/English |
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- Case Report -
A Case of Thymoma with Cystic Lesion Completely Resected by Cervical and Thoracoscopic Approach
Ryo Karita1, Taiki Fujiwara1, Hiroki Matsumoto1, Mitsutoshi Shiba1, Tomohiko Iida11Department of Thoracic Surgery, Kimitsu Chuo Hospital, Japan
Background. Recently, thoracoscopic and robotic surgery have become the mainstay for mediastinal tumors. When the tumor is large, an inadequate field of view cannot be obtained, and safety issues remain. Case. The patient was a male in his 20s. He was referred to our hospital because of an abnormal chest shadow on a chest X-ray. A computed tomography (CT) scan showed a mass with a maximum diameter of 11 cm in the anterior mediastinum, which progressed to the lower pole of the left lobe of the thyroid gland. On thoracic magnetic resonance imaging (MRI), most of the tumor was suspicious for a cyst, and the largest substantial component was 4 cm in diameter. Since it was unclear whether the tumor was malignant or not, we decided to operate for the purpose of diagnostic treatment. Due to the young age of the patient and in order to preserve his quality of life, we decided to avoid a median sternotomy and remove the tumor by neck manipulation (performed by the otolaryngology department) and thoracoscopic manipulation (performed by our department). The inferior thyroid vein was dissected, and the tumor was dissected to the superior border of the left brachiocephalic vein. The patient was then transferred for three-port thoracoscopic surgery. The tumor was dissected and removed using the dissected edge of the inferior thyroid vein as a landmark. The tumor volume was reduced by aspiration of cystic fluid. The patient had a good postoperative course and was discharged 5 days after surgery. The pathological diagnosis was Masaoka stage I thymoma with cystic lesion, WHO classification type B2. Conclusion. In combination with neck manipulation, safe thoracoscopic resection was possible. We reported a case of thymoma that could be safely resected thoracoscopically by combining neck manipulation with tumor volume reduction by the aspiration of cystic fluid.
key words: Thymoma, Thoracoscopic surgery, Cervical approach
Received: November 16, 2023
Accepted: February 22, 2024
JJLC 64 (3): 168-173, 2024
