2019 Volume 33 Issue 1 Pages 63-67
Based on the tumor size and localization, surgery for an anterior mediastinal tumor commonly involves either sternotomy or video-assisted thoracoscopy; both procedures have their own advantages and disadvantages. Here, we describe a case wherein an inverted L-shaped mini-sternotomy combined with video-assisted thoracoscopy was performed to resect an anterior mediastinal tumor.
An 81-year old male undergoing a regular medical examination was incidentally diagnosed with an anterior mediastinal tumor. The tumor grew from 25 to 33 mm during a follow-up period of 18 months. Consequently, he was referred to our hospital for a suspected thymoma. The tumor was adjacent to the innominate vein. We decided on an inverted L-shaped mini-sternotomy combined with video-assisted thoracoscopy to secure a good surgical field. The thoracoscopic view did not initially reveal the tumor or any metastasis; however, the tumor and thymic artery were detected following the courses of the right phrenic nerve and right inner thoracic artery and vein. Further, the sternotomy incision, which afforded a good view, revealed that the thymic vein arose from the innominate vein. Hence, we were able to safely and completely remove the tumor and thymus. The postoperative pathological diagnosis revealed the tumor to be an atypical carcinoid of the thymus.
