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Koji Saito
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EP1.15 - Thymoma/Other Thoracic Malignancies (ID 205)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.15-23 - Cardiac Tamponade Caused by a Type A Thymoma: A Case Report (Now Available) (ID 404)
08:00 - 18:00 | Author(s): Koji Saito
- Abstract
Background
Thymomas, the commonest neoplasm of the anterior mediastinum, are characteristically asymptomatic for prolonged periods. Most patients with disseminated disease have significant signs and symptoms such as chest pain or discomfort, dyspnea, and superior vena cava syndrome. Hemorrhagic pericardial tamponade is an uncommon initial manifestation and it is particularly rare for a thymoma to present with pericardial tamponade. We here present a 73 year-old man who was admitted to our institution with fever and shortness of breath and diagnosed with hemorrhagic pericardial tamponade resulting from a Type A thymoma.
Method
The patient presented to our emergency department in a stable condition and reported no previous trauma or muscular weakness. Chest computed tomography (CT) showed a cardiac effusion, an anterio-superior mediastinal 40×39×38 mm mass and enlarged mediastinal lymph nodes (image). After a hemorrhagic pericardial effusion had been drained, PET-CT performed to further investigate the mediastinal mass showed increased uptake in the mediastinum and right gluteus maximus muscle. Examination of a needle biopsy from the right gluteus maximus muscle mass revealed schwannoma. We therefore suspected the mediastinal mass was a metastatic schwannoma and performed VATS thymectomy combined with partial pericardiectomy.
Result
Histopathological evaluation of the operative specimen revealed a Type A thymoma that was T3 (cardiac) M1aN0 pStage IVa and Masaoka-Koga stage III. The tumor had invaded the cardiac structures. The patient was discharged on the eighth postoperative day. Radiation therapy (50Gy/25Fr) was started three months later. A chest CT taken 9 months postoperatively did not reveal any metastasis.
Conclusion
We here present a remarkable case of Type A thymoma extending into the pericardium and causing cardiac tamponade that was successfully resected after evacuating a hemorrhagic pericardial effusion.