Open surgical treatment of superior vena cava syndrome due to invasive thymoma

Abstract

Here we describe a case of open surgery for superior vena cava syndrome due to invasive thymoma. An 85-year-old woman presented with facial swelling and exertional dyspnea. Computed axial tomography revealed a thymoma in the mediastinum, extending to the superior vena cava, right atrium, and bilateral brachiocephalic veins. Endovascular therapy did not seem feasible because superior vena cava appeared totally occluded, and stenting could cause tumor embolism to the pulmonary arteries. Open surgery facilitated macroscopically complete and successful tumor resection. If long-term survival seems possible, open surgery could be a viable treatment option for superior vena cava syndrome that is ineligible for endovascular therapy.

Should endovascular stenting be used routinely as first-line treatment for malignant superior vena cava syndrome?—a critical review in the context of recent advances in oncological treatments

“…Surgical resection of the tumour followed by venous bypass or reconstruction is theoretically an option (10), but it is rarely performed in patients with stage IV malignancies, and it is not the most definitive oncologic therapy in light of the histologies most associated with SVCS. It may, however, be considered in thymic tumour patients as part of a multimodality treatment (11,12).…”