Surgical treatment of thymoma.
OBJECTIVE
A case report is presented of a 66-year-old white woman with a 3-month history of atypical chest pain and shortness of breath.


METHODS
A lateral chest radiograph demonstrated an anterior mediastinal density. A subsequent computed tomography (CT) scan revealed a mass in the right anterolateral mediastinum. Fine-needle aspiration (FNA) revealed tumor cells positive for cytokeratin and negative for leukocyte common antigen.


RESULTS
The differential diagnosis at that time included thymoma versus thymic carcinoid. She underwent a median sternotomy with complete thymectomy. The pathology revealed a large thymoma with microinvasion into the surrounding adipose tissue. She had an uneventful postoperative course and later underwent adjuvant radiation therapy.


CONCLUSIONS
Surgical treatment of thymoma is discussed, with emphasis on diagnosis and treatment. Although some patients may present with symptoms caused by involvement of surrounding structures, most thymomas are discovered incidentally on chest radiograph. Various diagnostic procedures can aid the surgeon in ruling out other neoplasms, such as lymphoma or germ cell tumors. Prognosis is not based on histology, but on the tumor's gross characteristics at operation. Benign tumors are noninvasive and encapsulated. All patients with potentially resectable lesions should undergo en-bloc excision. Radiation or chemotherapy should be instituted in more advanced tumors.
Miller
Quintessa
Q
Department of Cardiovascular Thoracic Surgery, Keesler Medical Center, Keesler Air Force Base, Mississippi, USA.
Moulton
Michael J
MJ
Pratt
Jerry
J