Invasive thymoma reduced by preoperative chemotherapy ; a case report

Abstract

A 17-year-old man was admitted to our hospital because of facial edema and an abnormal shadow on a chest X-ray film. A mass was demonstrated in the anterosuperior mediastinum by chest X-ray examination and chest CT scan. A diagnosis of thymoma was made by percutaneous biopsy. It was stage III in Masaoka's classification, so we chose preoperative chemotherapy. The patient received 2 courses of combination chemotherapy consisting of CDDP, ADM, VCR and CPA prior to surgery. The superior vena cava syndrome disappeared and the tumor was markedly reduced in size. The tumor could be removed totally through only a partial resection of the pleura. Histopathological examination revealed mixed thymoma with necrosis and fibrosis throughout the lesion. After surgery the patient received 40 Gy irradiation to the superior mediastinum. In this case invasive thymoma responded so well to combination chemotherapy, including CDDP, that total resection was possible and was well tolerated.