A case of multilocular thymic cysts with thymoma that presented with mediastinitis

Momose, Kazutaka; Nishi, Satoshi; Mishima, Osamu; Kitano, Morihisa; Kitazawa, Tsutomu; Yoshioka, Teruaki

doi:10.2995/jacsurg.25.074

Cited by 1 publication

(2 citation statements)

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“…These reports showed adhesion with surrounding organs as intraoperative findings (six cases), pleural effusion (eight cases), and necrosis as pathological findings (seven cases). Similar to the reported cases [ 2 , 5 – 7 , 9 , 10 ], in our case, intraoperative findings also showed strong adhesions to surrounding the organs. Thus, although no obvious fever or pleural effusion was observed, mediastinal and partial pleuritis could have been present and was thought to have caused the chest pain.…”

Section: Discussionsupporting

confidence: 91%

“…It is speculated that MTCs are caused by an acquired inflammatory process in structures derived from the medullary duct epithelium such as Hassall corpuscles. Misawa et al argued that the cyst ruptured and caused inflammation which resulted in chest pain [ 7 ]. On the other hand, in our case, it is probable that embolism which occurred in the thymus resulted in necrosis and chest pain.…”

Section: Discussionmentioning

confidence: 99%

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A rare case of combined thymoma and a multilocular thymic cyst discovered due to chest pain

et al. 2021

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Background A thymoma with chest pain and multilocular thymic cysts (MTCs) is very rare. Case presentation A 49-year-old man presented to another hospital complaining of an anterior chest pain. Chest computed tomography (CT) showed an anterior mediastinal tumor 60 × 30 × 55 mm in size. The boundary with the pericardium or left brachiocephalic vein seemed to be partially unclear while enhanced by the contrast medium, and so the tumor could have invaded them. No definitive diagnosis of myasthenia gravis was made although the serum anti-acetylcholine receptor antibody count was high. We performed an extended thymectomy with combined partial resection of left brachiocephalic vein, left upper lobe, and left phrenic nerve. He was discharged with no chest pain and no complications post-surgery. The tumor was pathologically type B2 thymoma with hemorrhage necrosis and MTCs, and we diagnosed Masaoka stage II because of no histological infiltration to the organs. Conclusions We speculated that hemorrhagic necrosis due to infarction in tumor caused the inflammation to spread to the surrounding organs, which was related to the chest pain and the development of MTCs.

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