Recurrent Thymic Carcinoma Treated With Median Sternotomy, Innominate Vein Replacement for Superior Vena Cava, and Iodide Implantation: A Case Report and Review of the Literature
ABSTRACT Background Neuroendocrine tumors of the thymus (NETT) are rare and malignant tumors that arise in the anterior mediastinum. These tumors can exhibit aggressive behavior and may involve surrounding critical structures, such as the superior vena cava. This case contributes to the literature b...
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2025-01-01
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| Online Access: | https://doi.org/10.1002/cnr2.70089 |
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| author | Zhong‐zheng Chen Wen‐dong Qu Xing‐shu Zhang Yong‐xiang Song |
| author_facet | Zhong‐zheng Chen Wen‐dong Qu Xing‐shu Zhang Yong‐xiang Song |
| author_sort | Zhong‐zheng Chen |
| collection | DOAJ |
| description | ABSTRACT Background Neuroendocrine tumors of the thymus (NETT) are rare and malignant tumors that arise in the anterior mediastinum. These tumors can exhibit aggressive behavior and may involve surrounding critical structures, such as the superior vena cava. This case contributes to the literature by presenting a recurrent thymic carcinoma with invasion of major blood vessels, including the superior vena cava, and the complexities involved in its surgical management. Case A 51‐year‐old male with no significant medical history presented with eyelid edema and a mediastinal mass. Diagnostic imaging, including positron emission tomography/computed tomography (PET/CT), revealed a malignant anterior mediastinal mass with possible metastasis. The patient underwent thoracoscopic resection of the tumor and wedge resection of the left upper lobe of the lung. Postoperative pathology confirmed a neuroendocrine carcinoma (G3), staged as Masaoka IVa. Despite aggressive surgery, the patient developed recurrent metastasis involving mediastinal lymph nodes and the superior vena cava. The patient underwent complex surgery involving vascular replacement, pericardial resection, and superior vena cava reconstruction, followed by adjuvant chemotherapy, radiotherapy, and immunotherapy. Conclusion This case highlights the challenges of managing advanced NETT, particularly with invasion of major vascular structures. It emphasizes the importance of early diagnosis, complete surgical resection, and tailored adjuvant therapies, including chemotherapy, radiotherapy, and immunotherapy, to improve survival outcomes. The lessons learned from this case contribute to refining treatment strategies for similar cases, advocating for aggressive surgical approaches and the potential benefit of novel therapeutic agents in the management of advanced NETT. |
| format | Article |
| id | doaj-art-f3512e7ebd00413fa14f9223e3a2a15a |
| institution | Kabale University |
| issn | 2573-8348 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| spelling | doaj-art-f3512e7ebd00413fa14f9223e3a2a15a2025-01-30T15:46:35ZengWileyCancer Reports2573-83482025-01-0181n/an/a10.1002/cnr2.70089Recurrent Thymic Carcinoma Treated With Median Sternotomy, Innominate Vein Replacement for Superior Vena Cava, and Iodide Implantation: A Case Report and Review of the LiteratureZhong‐zheng Chen0Wen‐dong Qu1Xing‐shu Zhang2Yong‐xiang Song3Department of Thoracic Surgery Affiliated Hospital of Zunyi Medical College Zunyi People's Republic of ChinaDepartment of Thoracic Surgery Affiliated Hospital of Zunyi Medical College Zunyi People's Republic of ChinaDepartment of Thoracic Surgery Affiliated Hospital of Zunyi Medical College Zunyi People's Republic of ChinaDepartment of Thoracic Surgery Affiliated Hospital of Zunyi Medical College Zunyi People's Republic of ChinaABSTRACT Background Neuroendocrine tumors of the thymus (NETT) are rare and malignant tumors that arise in the anterior mediastinum. These tumors can exhibit aggressive behavior and may involve surrounding critical structures, such as the superior vena cava. This case contributes to the literature by presenting a recurrent thymic carcinoma with invasion of major blood vessels, including the superior vena cava, and the complexities involved in its surgical management. Case A 51‐year‐old male with no significant medical history presented with eyelid edema and a mediastinal mass. Diagnostic imaging, including positron emission tomography/computed tomography (PET/CT), revealed a malignant anterior mediastinal mass with possible metastasis. The patient underwent thoracoscopic resection of the tumor and wedge resection of the left upper lobe of the lung. Postoperative pathology confirmed a neuroendocrine carcinoma (G3), staged as Masaoka IVa. Despite aggressive surgery, the patient developed recurrent metastasis involving mediastinal lymph nodes and the superior vena cava. The patient underwent complex surgery involving vascular replacement, pericardial resection, and superior vena cava reconstruction, followed by adjuvant chemotherapy, radiotherapy, and immunotherapy. Conclusion This case highlights the challenges of managing advanced NETT, particularly with invasion of major vascular structures. It emphasizes the importance of early diagnosis, complete surgical resection, and tailored adjuvant therapies, including chemotherapy, radiotherapy, and immunotherapy, to improve survival outcomes. The lessons learned from this case contribute to refining treatment strategies for similar cases, advocating for aggressive surgical approaches and the potential benefit of novel therapeutic agents in the management of advanced NETT.https://doi.org/10.1002/cnr2.70089chemotherapyimmunotherapyneuroendocrine tumors of the thymus (NETT)superior vena cavasurgical resectionthymic carcinoma |
| spellingShingle | Zhong‐zheng Chen Wen‐dong Qu Xing‐shu Zhang Yong‐xiang Song Recurrent Thymic Carcinoma Treated With Median Sternotomy, Innominate Vein Replacement for Superior Vena Cava, and Iodide Implantation: A Case Report and Review of the Literature Cancer Reports chemotherapy immunotherapy neuroendocrine tumors of the thymus (NETT) superior vena cava surgical resection thymic carcinoma |
| title | Recurrent Thymic Carcinoma Treated With Median Sternotomy, Innominate Vein Replacement for Superior Vena Cava, and Iodide Implantation: A Case Report and Review of the Literature |
| title_full | Recurrent Thymic Carcinoma Treated With Median Sternotomy, Innominate Vein Replacement for Superior Vena Cava, and Iodide Implantation: A Case Report and Review of the Literature |
| title_fullStr | Recurrent Thymic Carcinoma Treated With Median Sternotomy, Innominate Vein Replacement for Superior Vena Cava, and Iodide Implantation: A Case Report and Review of the Literature |
| title_full_unstemmed | Recurrent Thymic Carcinoma Treated With Median Sternotomy, Innominate Vein Replacement for Superior Vena Cava, and Iodide Implantation: A Case Report and Review of the Literature |
| title_short | Recurrent Thymic Carcinoma Treated With Median Sternotomy, Innominate Vein Replacement for Superior Vena Cava, and Iodide Implantation: A Case Report and Review of the Literature |
| title_sort | recurrent thymic carcinoma treated with median sternotomy innominate vein replacement for superior vena cava and iodide implantation a case report and review of the literature |
| topic | chemotherapy immunotherapy neuroendocrine tumors of the thymus (NETT) superior vena cava surgical resection thymic carcinoma |
| url | https://doi.org/10.1002/cnr2.70089 |
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