1992 Volume 6 Issue 6 Pages 712-718
There are very few reports of the use of initial chemotherapy prior to surgery or radiotherapy for invasive thymoma. Three patients with bulky invasive thymoma received initial cisplatin-based chemotherapy. In Case 1 with a diagnosis of round-oval epithelial thymoma involving mediastinal great vessels, initial chemotherapy with CDDP, CPA, and VCR was given along with radiation, and complete remission was obtained. In Case 2, mixed epithelial thymoma invading the intrapericardial cavity with pericardial effusion and pleural effusion, initial chemotherapy with CDDP, and VP-16 was given. A partial remission was obtained, but liver dysfunction occurred. Radiotherapy was given preoperatively during liver dysfunction. Tumor extirpation was carried out with resection of the pericardium, left innonimate vein, and part of the left lung. The resected specimen showed diffuse fibrotic changes. Radiotherapy was given postoperatively. In Case 3, spindle epithelial thymoma involving the superior vena cava, initial chemotherapy with CDDP, and VP-16 was given, but no striking reduction in the size of the tumor was noted. The tumor was resected with the pericardium, superior vena cava, and part of the right lung. The superior vena cava was reconstructed with ringed EPTFE grafts. The resected specimen showed partial fibrotic changes. Radiotherapy was given postoperatively.
Initial chemotherapy now be considered prior to surgery or radiotherapy in patients presenting with bulky thymomas.
