Anterior Mediastinal Type B3 Invasive Thymoma with Multiple Intrapulmonary Metastases: A Case Report

幾乎從胸腺腫瘤轉移來的病灶都會侵入鄰近的器官或沿著肋膜或心包膜散佈。肺內轉移很少見而且大量多處的肺內轉移更是少見。我們將報告一位45歲沒有症狀的女性，她有侵襲性胸腺瘤伴隨多處肺部轉移。她的胸部電腦斷層掃描顯示前縱膈腔內有一個不規則形狀的鈣化腫瘤，而且在兩側肺實質內有多處的界線明顯而不同大小的腫瘤。她接受針對心臟後的轉移病灶做電腦斷層導向的切片檢查，細胞形態學上是紡錘型。根據世界衛生組織的分類一度被認為是A型胸腺腫瘤，前縱膈腔的腫瘤被切掉且被證實是B型。因為選擇不同的診斷工具，主要腫瘤和深部轉移的病灶其組織學上會不同是有可能的。胸腺腫瘤半隨大量多處的肺內轉移是相當少見的。要強調的是在這種情況下，胸腺切除來達成正確的診斷是必須要的。至於對侵襲性，最適宜的治療和長期的結果其不同處的影響仍然是未知的。

關鍵字

侵襲性胸腺瘤；多處的肺內轉移

並列摘要

Almost all metastatic lesions from thymomas invade adjacent organs or spread along the pleura or pericardium. Intrapulmonary metastases are rare, and extensive multiple intrapulmonary metastases are extremely rare. We report the case of an invasive thymoma with multiple lung metastases in an asymptomatic 45-year-old woman. Her chest computed tomographic (CT) scan showed an irregular-shaped calcified tumor in the anterior mediastinum and multiple well-defined variable-sized tumors in both lung parenchymas. She underwent a CT-guided biopsy of the retrocardial metastatic lesion. The morphology was spindle-shaped, which was once considered to be type A thymoma according to the World Health Organization classification. The anterior mediastinal tumor was resected and proved to be type B3. Differences in the histology between the main tumor and the deep-seated metastatic lesions are possible, depending on the choice of diagnostic tools. Thymoma with extensive multiple intrapulmonary metastases is extremely rare. It should be emphasized that thymectomy is necessary to achieve a correct diagnosis in this condition. The influence of the differences on invasiveness, best treatment, and long-term outcome remains unclear.

並列關鍵字

invasive thymoma ； type B3 ； type A ； multiple intrapulmonary metastases

國際替代計量

Anterior Mediastinal Type B3 Invasive Thymoma with Multiple Intrapulmonary Metastases: A Case Report

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