# Wide en-bloc thymectomy and venous axis reconstruction in Masaoka stage IIIB thymoma: a case report and literature review

## TL;DR

A 36-year-old man with advanced thymoma underwent complex surgery involving thymectomy and venous reconstruction, followed by chemotherapy with no recurrence after 3 months.

## Contribution

This case report presents a successful surgical and chemotherapeutic approach for Masaoka stage IIIB thymoma with venous axis reconstruction.

## Key findings

- En-bloc thymectomy and venous bypass using a Dacron graft were successfully performed.
- Neoadjuvant chemotherapy followed by surgery led to no recurrence after 3 months of follow-up.
- Pericardiectomy and diaphragm metastasis resection were part of the comprehensive treatment strategy.

## Abstract

Thymomas are rare tumors originating from thymic tissue and rarely metastasize. They can be diagnosed either incidentally or symptomatically when compressing or invading nearby structure. A 36-year-old man presented with significant high-grade fever, chest pain that worsens upon lying down, and dyspnea. A chest X-Ray and computed tomography followed by biopsy confirmed the diagnosis of thymoma. The management included chemotherapy cycles, followed by surgery. Pericardiectomy was performed with en-bloc thymectomy and partial resection of the infiltrating lung. Venous drainage was restored by 8/16 mm inverted bifurcated brachiocephalic-superior vena cava Dacron bypass. The pericardium was reconstructed by a synthetic Dacron patch, and the right diaphragm metastasis was resected. Neoadjuvant chemotherapy was initiated. After 3 months of follow-up, no recurrence was evidenced by computed tomography.