title: Resection of thymic carcinoma in a patient with thoracic aortic aneurysm.
abstract: A 72-year-old man with a history of brain infarction presented with left sided anterior chest pain secondary to a thymic carcinoma. He received induction radiotherapy, 45 Gy. Preoperative computed tomography showed the tumor was adherent to a thoracic aortic aneurysm (TAA) which had extensive mural thrombus and calcification. To obtain adequate exposure without exerting tension on the fragile aneurysmal wall, ribs were resected to allow us to separate the tumor from the TAA, after which median sternotomy was performed uneventfully, creating generous exposure. The tumor had invaded the sternum, ribs, innominate vein, phrenic and recurrent laryngeal nerves, and lung. The tumor was removed en bloc, and the chest wall was reconstructed. Intra- and post-operative brain infarction and rupture of the TAA were avoided. The patient is alive and well without recurrence 10 months after surgery.
authors.affiliation: First Department of Surgery, Showa University School of Medicin, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Nonaka
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Kadokura
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kataoka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Bito
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Asano
authors.forename: Tadanori
authors.initials: T
authors.lastname: Kawada
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Takaba
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kunimura
authors.forename: Tamio
authors.initials: T
authors.lastname: Kushihashi
authors.forename: Shuichi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000150:complications*; D006801:Humans; D008297:Male; D013945:Thymoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013950:Thymus Gland / Q000473:pathology; D013953:Thymus Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed