Extirpation and prosthetics of the superior vena cava in recurrent thymoma B3

• Kononets P.V.
• Charchyan E.R.
• Amir G. Abdullaev
• Sytov A.V.
• Obukhova O.A.
• Ilya V. Eltsov

Abstract

Background. It is known that the frequency of local recurrence of thymoma B3 after thymectomy can reach 8-30% of cases. However, even if it is necessary to resect adjacent mediastinal atomic structures, the proportion of repeated radical operations according to the literature is 45-71%, which provides an overall 5-year survival rate of 72%.

The aim of the work is to present a clinical case of successful removal of recurrent thymoma B3 with extirpation and prosthetics of the superior vena cava.

Material and methods. The 59-year old patient, was admitted to the hospital with a clinical diagnosis: malignant neoplasm of the thymus gland, thymoma B3. Surgical treatment 2010. Relapse 2018. Chemoradiotherapy December 2018 (SOD 35 Gr + carboplatin, 3 courses). Stabilization. A planned sternotomy, removal of a recurrent tumor, extirpation and prosthetics of the superior vena cava using a Y-shaped prosthesis with resection of both diaphragmatic nerves were performed. The early postoperative period was complicated by respiratory failure due to bilateral paresis of the diaphragm, which was stopped by prolonged artificial ventilation, rehabilitation and rehabilitation treatment.

Results. At the control examination after 12 months, the patient's condition is satisfactory, he is able to perform moderate physical labor, there is no data for the recurrence of the tumor process in the mediastinum, there is incomplete recanalization of the left brachiocephalic branch of the Y-shaped prosthesis of the superior vena cava. According to spirometry - moderate restrictive violations of pulmonary ventilation.

Conclusion. Surgical treatment of recurrent invasive thymoma with extirpation and prosthetics of the superior vena cava allows us to hope for favorable immediate and long-term results.

Keywords:recurrent thymoma, prosthetics of the superior vena cava

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