2020 Volume 60 Issue 3 Pages 181-186
Background. The optimum treatment strategy for invasive thymomas with pleural dissemination remains unclear. Case. The patient was a 67-year-old woman. She was diagnosed with an anterior mediastinal tumor with left brachiocephalic vein invasion and pleural dissemination based on computed tomography (CT). We diagnosed the tumor as Masaoka clinical stage IVa thymoma by CT-guided biopsy. She received induction chemotherapy with cisplatin, doxorubicin and methylprednisolone (CAMP therapy). After four cycles of CAMP therapy, since CT revealed the remarkable reduction of primary lesion and near disappearance of pleural dissemination, we performed resection of the residual tumor. We completely removed the primary lesion with the left brachiocephalic vein and part of the pericardium, as well as the pleural dissemination via median sternotomy with video-assisted thoracoscopic surgery. At the time of writing, she is alive without recurrence at 17 months after surgery. Conclusion. We experienced a case of macroscopic complete excision of stage IVa thymoma after induction chemotherapy.
