Zusammenfassung
GRUNDLAGEN: Das Thymom, ein epithelialer prämaligner Tumor, entsteht normalerweise im antero-superioren Mediastinum und kann mit Myasthenie assoziiert sein. METHODIK: Ein 41-jähriger Mann, initial mit asymptomatischer pleurokardialer Zyste diagnostiziert, zeigte nach 6 Jahren ein zystisches Thymom mit Symptomen der Myasthenie. ERGEBNISSE: Die präoperative Diagnose wurde entsprechend Klinik, Immuntests und Thorax-CT gestellt. Über eine mediane Sternotomie wurde die Thymektomie durchgeführt. Die Histologie zeigte ein Typ AB Thymom (WHO Stadium I nach Masaoka). Obwohl anfänglich eine künstliche Beatmung und eine immunsuppressive Therapie notwendig waren, wurde der Patient nach 32 Tagen ohne Myasthenie-Symptome entlassen. SCHLUSSFOLGERUNGEN: Die untypische Lokalisation, Morphologie verzögerten die Diagnose und die chirurgische Entfernung des Thymoms.
Summary
BACKGROUND: Thymoma, an epithelial thymic tumor with malignant potential is usually located in the antero-superior mediastinum and may be associated with myasthenia. METHODS (case report): The medical files of a 41-year old male patient, initially diagnosed with an asymptomatic pleuropericardial cyst, but 6 years later reconsidered to be a cystic thymoma due to occurrence of myasthenic symptoms, were reviewed. RESULTS: The preoperative diagnosis was based on the clinical picture, immunological test, and thorax computertomography. An extended thymomectomy was performed using a median longitudinal sternotomy. The histological evaluation of the tumor revealed a thymoma type AB according to WHO or stage I according to Masaoka. Although postoperatively mechanical ventilation and immunosuppressive treatment were required, the patient was discharged 32 days later in almost complete remission of myasthenic symptoms. CONCLUSIONS: Unusual location of the tumor, cystic appearance and the initial absence of myasthenic symptoms misled to the diagnosis of pleuropericardial cyst and delayed surgical removal.
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Ionescu, L., Dragomir, C., Dănilă, R. et al. Ectopic thymoma mimicking a pleuropericardial cyst: a case report. Eur Surg 42, 194–196 (2010). https://doi.org/10.1007/s10353-010-0551-0
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DOI: https://doi.org/10.1007/s10353-010-0551-0