Thymoma

Thymoma is a malignant tumor of the thymus gland.

In this disease, metastases mainly spread in the chest: the pleura (the shell that tightly fits the lungs and the wall of the chest cavity), the pericardium (the outer connective tissue membrane of the heart), the diaphragm, which occur rarely, but in some cases, relapses occur more than 10 years after surgical treatment.

This disease accounts for 20-25 % of all mediastinal tumors. The peak incidence is between 35 and 70 years.

According to the World Health Organization system, there are six types of tim: A, AB, B1, B2, B3, C. As the progression from A to C progresses, the prognosis worsens, and the survival rate decreases.

Symptoms of thymoma:

In 30 % of cases, the disease is asymptomatic, and often accidentally detected by X-ray examination. About 40 % of patients complain of pain in the chest area, cough, associated with local exposure to the tumor. The main feature of this tumor is the association with autoimmune pathology, immunodeficiency and autoimmune reactions of the body. The most frequent and severe manifestation of autoimmune disorders is myasthenic syndrome (a disease of the nervous and muscular system, which is characterized by weakness and pathological fatigue of the striated muscles), as well as in rare cases anemia. Often, thymomas are combined with other immune disorders, such as leukemia, lymphoma, and rheumatoid arthritis.

Patients with thymomas have an increased risk of developing additional malignancies of various localizations.

Diagnostics:

• Multispiral computed tomography (MSCT) with contrast.

• X-ray of the chest organs.

• Magnetic resonance imaging (MRI).

• Positron emission tomography combined with CT (PET-CT).

• Fine needle aspiration biopsy (TAB) is a method of morphological verification of mediastinal neoplasms.

• Ultrasound.

Recommended treatment:

• Neoadjuvant therapy according to the CAP scheme (cyclophosphamide, doxorubicin, cisplatin.

• - Radiation therapy SOD 50 Gr.

• - Surgical methods of treatment, including minimally invasive thoracoscopic operations on the thymus gland.

Clinical case of a patient of the MCSC.

A 38-year-old man has applied to the MCSC with complaints of weakness in his hands. The first symptoms appeared in 2017, but after the condition worsened in 2018, he turned to our Center. During the examination by the specialists of the MCSC, the patient was diagnosed with facial nerve neuritis. The necessary therapy was carried out, which temporarily gave a positive effect.

In March 2019, the patient had difficulty breathing and swallowing, so he was hospitalized with suspected angioedema. After examination by an ENT doctor, angioedema was excluded, and a neurologist diagnosed myasthenia gravis as a progressive form, bulbar type. During the follow-up examination, ultrasound and CT scans were performed in the MCSC and a thymus tumor formation was detected.

MRI scan:

The patient underwent conservative therapy, after which he was hospitalized for thoracoscopic thymomectomy.

The patient underwent thoracoscopic removal of the thymus tumor, and the removed material was sent for routine pathomorphological examination.

Histological picture:

This histological type of thymoma is characterized by the best prognosis in the case of radical surgery. The specialists of our Center have prescribed the optimal treatment for the patient, aimed at reducing the risk of relapses of this disease and improving the quality of life. The patient is discharged, at the moment feels well, has no complaints.

This pathology is rare, the incidence of the disease is 0.13% per 100,000 population. This is associated with the difficulty of examination for a reliable diagnosis, which requires the patient to timely contact highly specialized medical institutions.