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J Thorac Cardiovasc Surg 2007;134:1364-1365
© 2007 The American Association for Thoracic Surgery

Brief Communication

Extended operation for recurrent thymic carcinoma presenting with intracaval growth and intracardiac extension

Department of Thoracic Surgery, University of Rome "Sapienza," Policlinico Umberto I, Rome, Italy.

Received for publication March 28, 2007; revisions received May 3, 2007; accepted for publication May 14, 2007.

^_* Address for reprints: Tiziano De Giacomo, MD, University of Rome "Sapienza," Policlinico Umberto I, Viale del Policlinico 155, 00159 Rome, Italy. (Email: tiziano.degiacomo@tin.it).

The first 20% of the full text of this article appears below.

Thymic carcinoma is a relatively uncommon tumor that represents less than 1% of thymic malignancies. The prognosis is often poor, with a 5-year survival for all patients of between 31% and 50%.¹ At present, a multimodality approach including aggressive surgical resection, platinum-based combination chemotherapy, and radiotherapy seems the preferred therapeutic strategy. Overall recurrence rate is very high and vascular invasion is particularly associated with poor prognosis.^2,3 Only aggressive and complete resection yields long-term survival. We report the management of recurrent thymic carcinoma with extension into the right atrium, resulting from the progression of intracaval growth, 4 years after induction chemotherapy and successful total resection followed by chemoradiation treatment.

Clinical Summary

A 46-year-old man with sudden engorgement of neck veins, swelling of the face, and mild ocular myasthenia was admitted to our institution. Recurrence of thymic carcinoma was suspected inasmuch as the patient had undergone radical resection, with negative resection margins, of thymic carcinoma 4 years earlier, after induction chemotherapy. The patient received postoperative adjuvant therapy, including 6 . . . [Full Text of this Article]

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