[Value of x-ray computed tomography in assessing the extent of invasive lympho-epithelial thymoma in the adult. Therapeutic implications].
This study concerns 12 patients who were in hospital for the work-up and treatment of an invasive lympho-epithelial thymoma. The extent of the disease was studied by systemic computed tomographic (CT) scanning of the thorax and abdomen. Three patients out of nine examined presented initially with asymptomatic renal metastasis. Three patients were treated straight away by poly-chemotherapy; the nine others benefitted either from radiotherapy alone (four cases) or from radiotherapy associated with surgery (4 cases) or an isolated surgical exploration (1 case). CT examination was carried out in 11 patients 3 months after the beginning of treatment and 7 times clinically latent metastasis were rediscovered (renal, adrenal, hepatic, thyroid, cerebral and osseous). These 11 patients benefitted secondarily from polychemotherapy. The results confirm the gravity of the condition: only three patients are living and in complete remission with a follow up of 24 to 48 months. The frequency of latent metastasis, detected by CT scanning, during the course of a malignant thymoma justifies the systematic performance of this examination in the work up of the disease extent and therapeutic surveillance in these patients, and leads one to reconsider the place of chemotherapy in the therapeutic strategy of these tumours.
D000306:Adrenal Cortex Neoplasms / Q000556:secondary; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000556:secondary; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D013945:Thymoma / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy; D013953:Thymus Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000008:administration & dosage
D001761:Bleomycin; D011344:Procarbazine; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
Intérêt de la tomodensitométrie dans le bilan d'extension des thymomes lympho-épithéliaux invasifs de l'adulte. Implications thérapeutiques.