Redical resection of thymic carcinoid with infiltration into the SVC-a report of two cases and review of the Japanese literature.
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概要
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Two patients with thymic carcinoid with infiltration into the SVC were treated surgically. The 49 cases reported in the Japanese literature are reviewed. Case 1 was a 56-year-old man with precardial pressure sensation in whom mediastinal tumor was found by chest radiography. In August 1986, using an intra-SVC shunt, we performed total tumorectomy, including total thymectomy, mediastinal lymph node dissection and partial resection of the SVC. The tumor was 8.5×8×6 cm in size. The pathohistological diagnosis was thymic carcinoid with venous infiltration. Postoperative radiotherapy was performed. The patient is good health without relapse 2 year and 10 months after operation. Case 2 was a 60-year-old man in whom thymic carcinoid was diagnosed by puncture cytologic examination under CT guidance. In May 1989, using a bypass with a ringed e-PTFE from the right atrium to the left brachiocephalic vein, we performed total tumorectomy with total thymectomy, mediastinal lymph node dissection, resection of the SVC, and using a ringed e-PTFE from the right atrium to the right brachiocephalic vein, we reconstructed the SVC. The tumor was 10×10×7 cm in size. The pathohistological diagnosis was thymic carcinoid with metastasis to mediastinal lymph nodes and venous infiltration. The patient is in good health with both grafts patent and without relapse 2 months after operation. Therefore, this tumor, which may have low malignancy but can cause infiltration and/or metastasis, should be resected as early and as extensively as possible, including mediastinal lymph node dissection. Venous replacement by artificial veins is considered to be important since it can increase the radical curability of malignant tumors.
- 特定非営利活動法人 日本呼吸器外科学会の論文