Extirpation and prosthetics of the superior vena cava in recurrent thymoma B3
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
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
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
Funding. The study had no sponsor support.
Conflict of interests. The authors declare no conflict of interests.
For citation: Kononets P.V., Charchyan E.R., Abdullaev A.G., Sytov
A.V., Obukhova O.A., Eltsov I.V. Extirpation and prosthetics of the superior
vena cava in recurrent thymoma B3. Clinical and Experimental Surgery. Petrovsky
Journal. 2021; 9 (1): 84-8. DOI: https://doi.org/10.33029/2308-1198-2021-9-1-84-88 (in Russian)
1. Guerrera F., Rendina E., Venuta F., et al. Does the World Health Organization histological classification predict outcomes after thymomectomy? Results of a multicenter study on 750 patients. Eur J Cardiothorac Surg. 2015; 48 (1): 48-54. DOI: https://doi.org/10.1093/ejcts/ezu368
2. Kaba E, Ozkan B, Ozyurtkan M.O., et al. Superior vena cava resection and reconstruction in mediastinal tumors and benign diseases. Turk Gogus Kalp Damar Cerrahisi Derg. 2018; 26 (1): 99-107. DOI: https://doi.org/10.5606/tgkdc.dergisi.2018.14292
3. Koper B, Kaplan T, Gdnal N., et al. Long-term survival after R0 resection of thymoma. Asian Cardiovasc Thorac Ann. 2018; 26 (6): 461-6.
4. Kondo K., Monden Y. Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg. 2003; 76 (3): 878-84.
5. Lee G.D., Kim H.R., Choi S.H., et al. Prosthetic graft interposition of the brachiocephalic veins or superior vena cava combined with resection of malignant tumours: graft patency and risk factors for graft occlusion. J Thorac Dis. 2016; 8 (1): 61-7. DOI: https://doi.org/10.3978/j.issn.2072-1439. 2016.01.07
6. Maurizi G., Poggi C., D’Andrilli A., Vanni C., et al. Superior vena cava replacement for thymic malignancies. Ann Thorac Surg. 2019; 107 (2): 386-92. DOI: https:// doi.org/10.1016/j.athoracsur. 2018.08.060.
7. Raica M., Ribatti D. Head and neck: thymus: thymoma: an overview. Atlas Genet Cytogenet Oncol Haematol. 2013; 17 (3): 221-8.
8. Rena O., Papalia E., MaggiG., et al. World Health Organization histologic classification: an independent prognostic factor in resected thymomas. Lung Cancer. 2005; 50 (1): 59-66.
9. Weissferdt A., Kalhor N. Bishop J., et al. Thymoma: a clinicopathological correlation of 1470 cases. Hum Pathol. 2018; 73: 7-15. DOI: https://doi.org/10.1016/j.humpath.2017.08.018
10. Zhao J., Bhatnagar V., Ding L., et al. A systematic review of paraneoplastic syndromes associated with thymoma: treatment modalities, recurrence, and outcomes in resected cases. J Thorac Cardiovasc Surg. 2020; 160 (1): 306-14.