Malignant thymoma metastatic to the pelvis: a rare case and considerations for management.
BACKGROUND
Thymoma is the most common tumor of the anterior mediastinum. Due to its relative rarity, its inconsistent clinical course and its frequent proximity to vital thoracic structures, management of this generally indolent tumor varies considerably. We present an unusual case of recurrent thymoma metastatic to the pelvis and review treatment experience employing surgical, radiotherapeutic and medical modalities.


METHODS
The present case is that of a 46-year-old woman with recurrent thymoma metastatic to a distal pelvic lymph node. Resection of the pelvic recurrence followed many years of local and systemic treatment for her thoracic primary tumor. Her case is unique for its involvement of pelvic anatomy and her clinical course marked by treatment-related congestive heart failure.


CONCLUSIONS
While the indolent clinical course of thyomoma frequently necessitates re-treatment and multi-modality therapy in patients suffering recurrences, treatment selection must take into account potential long-term morbidity and attendant quality of life. When anatomically and technically feasible, resection of recurrent disease should be considered in attempts to avoid potential cumulative and long-term toxicity resultant from radiotherapy and chemotherapy.
Elliott
Kevin S
KS
Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Box #24, Brooklyn, NY 11203, USA. Kevinselliott@aol.com
Borowsky
Mark E
ME
Bakdounes
Khldoun
K
Huang
Jennifer
J
Abulafia
Ovadia
O
Lee
Yi-Chun
YC
D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D010386:Pelvic Neoplasms / Q000556:secondary* / Q000628:therapy; D013945:Thymoma / Q000473:pathology* / Q000628:therapy