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Diagnosis, combined treatment, and long-term follow-up of a thymoma patient

https://doi.org/10.18093/0869-0189-2023-33-6-832-840

Abstract

Thymic neoplasms account for 20 – 25% of primary mediastinal tumors. Nonspecific clinical symptoms are often associated with delayed diagnosis of thymoma, leading to a distinctive problem of late diagnosis. Nowadays, surgical removal of the tumor is the method of choice for thymoma treatment. Combination treatment is indicated in the case of an unresectable tumor. Modern therapy (various combinations of anticancer drugs) helps reduce neoplasm size, stop metastasis, and maintain good quality of life in patients with thymoma.

Aim. The presented clinical case of type B3 thymoma (with invasion into surrounding organs and metastatic pleura) is characterized by a long asymptomatic period of the disease, the onset of symptoms after suffering COVID-19 (COronaVIrus Disease 2019) and successful long-term polychemotherapy. The causes of late diagnosis, as well as insufficient oncologic vigilance in evaluating the results of laboratory and instrumental tests, are discussed based on this clinical case.

Conclusion. A correct diagnosis, as well as successful treatment, requires a multidisciplinary approach involving physicians from different specialties – general practitioners, oncologists, surgeons, radiologists, and morphologists.

About the Authors

N. V. Chichkova
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Natalia V. Chichkova, Doctor of Medicine, Professor, Department of Faculty Therapy, Institute of Clinical Medicine.

Ul. Trubetskaya 8, build. 2, Moscow, 119991; tel.: (499) 248-77-47


Competing Interests:

The authors declare no conflict of interest



E. A. Kogan
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Evgenia A. Kogan - Doctor of Medicine, Professor, Institute of Clinical Morphology and Digital Pathology.

Ul. Trubetskaya 8, build. 2, Moscow, 119991; tel.: (499) 248-51-43


Competing Interests:

The authors declare no conflict of interest



V. V. Fomin
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Victor V. Fomin - Doctor of Medicine, Corresponding Member of Russian Academy of Sciences, Professor, Vice-Rector for Clinical Affairs and Additional Professional Education, Head of the Department of Faculty Therapy No.1, Institute of Clinical Medicine.

Ul. Trubetskaya 8, build. 2, Moscow, 119991; tel.: (495) 622-95-20


Competing Interests:

The authors declare no conflict of interest



V. D. Parshin
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); Federal State Budgetary Educational Institution of Additional Professional Education “Russian Medical Academy of Continuous Professional Education”, Ministry of Health of Russia
Russian Federation

Vladimir D.Parshin - Doctor of Medicine, Corresponding Member of the Russian Academy of Sciences, Surgeon-oncologist, Surgical Oncology Department, University Clinical Hospital No.1, FSA EIHE I.M.Sechenov (Sechenov University); Head of the Department of Thoracic Surgery, “Russian Medical Academy of Continuous Professional Education”.

Ul. Trubetskaya 8, build. 2, Moscow, 119991; Ul. Barrikadnaya 2/1, Moscow, 123995; tel.: (499) 248-58-08


Competing Interests:

The authors declare no conflict of interest



E. V. Fominykh
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Ekaterina V.Fominykh - Candidate of Medicine, Head of the Department of Radiology, University Clinical Hospital No.1.

Ul. Trubetskaya 8, build. 2, Moscow, 119991; tel.: (499) 248-59-26


Competing Interests:

The authors declare no conflict of interest



Yu. M. Bychkov
Federal State Budgetary Institution Russian Scientific Center of Roentgenoradiology (RSCRR) of the Ministry of Healthcare of the Russian Federation (Russian Scientific Center of Roentgenoradiology)
Russian Federation

Yuri M. Bychkov, Candidate of Medicine, Head of the Chemotherapy day Hospital.

Ul. Profsoyuznaya 86, Moscow, 117997; tel.: (985) 195-99-60


Competing Interests:

The authors declare no conflict of interest



N. V. Morozova
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Natalia V. Morozova - Candidate of Medicine, Head of the Therapeutic Department of University Clinical Hospital No.1.

Ul. Trubetskaya 8, build. 2, Moscow, 119991; tel.: (499) 248-45-23


Competing Interests:

The authors declare no conflict of interest



A. B. Ponomarev
Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Andrey B. Ponomarev - Candidate of Medicine, Associate Professor, Pathologist, Institute of Clinical Morphology and Digital Pathology.

Ul. Trubetskaya 8, build. 2, Moscow, 119991; tel.: (499) 248-51-43


Competing Interests:

The authors declare no conflict of interest



References

1. Barbolina T.D., Bychkov M.B., Allakhverdiyev A.K. et al. [Practical recommendations for drug treatment of thymus tumors (thymomas and thymic cancer). Zlokachestvennye opukholi. 2020; 10 (3s2-1): 603–614. Available at: https://rosoncoweb.ru/standarts/RUSSCO/2020/2020-35.pdf (in Russian).

2. Robinson S.P., Akhondi Y. Thymoma. In: StatPearls [Internet].Treasure Island (FL): StatPearls Publishing; 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK559291/

3. Yıldırım F., Mutlu M.Y., İçaçan OC., Bes C. Dermatomyositis associated with thymoma: a case report and literature review. Clin. Ter. 2023; 174 (2): 115–120. DOI: 10.7417/CT.2023.2506.

4. Álvarez-Velasco R., Gutiérrez-Gutiérrez G., Trujillo J.C. et al. Clinical characteristics and outcomes of thymoma-associated myasthenia gravis. Eur. J. Neurol. 2021; 28 (6): 2083–2091. DOI: 10.1111/ene.14820.

5. Liao C.H., Lyu S.Y., Chen Y.C. et al. Thymoma-related paraneoplastic syndrome mimicking reactive arthritis. Medicina. 2021, 57 (9): 932. DOI: 10.3390/medicina57090932.

6. Hung C.T., Tsai T.F., Chen J.S. et al. Thymoma-associated multiorgan autoimmunity. BMJ Case Rep. 2019; 12 (8): e229163. DOI: 10.1136/bcr-2018-229163.

7. Suzuki M., Watari T. Thymoma-associated pure red cell aplasia following femoral neck fracture. Cureus. 2022; 14 (2): e21836. DOI: 10.7759/cureus.21836.

8. Padda S.K., Yao.X., Antonicelli A. et al. Paraneoplastic syndromes and thymic malignancies: an examination of the International thymic malignancy interest group retrospective database. J. Thorac. Oncol. 2018; 13 (3): 436–446. DOI: 10.1016/j.jtho.2017.11.118.

9. Roden A.C. Mediastinum: Thymoma. PathologyOutlines.com, Inc, 2023. Available at: https://www.pathologyoutlines.com/topic/mediastinumthymoma.html

10. Aleksandrov O.A., Ryabov A.B., Pikin O.V. Thymoma (review of the literature). Sibirskiy onkologicheskiy zhurnal. 2017; 16 (4): 76–83. DOI: 10.21294/1814-4861-2017-16-4-76-83 (in Russian).

11. Brito‑Dellan N., Tsoukalas N., Font C. Thrombosis, cancer, and COVID‑19. Sup. Care Cancer. 2022; 30 (10): 8491–8500. DOI: 10.1007/s00520-022-07098-z.

12. Parshin V.D., Mirzoyan O.S., Titov V.A. et al. [Surgical treatment of giant thymoma complicated by intrathoracic compression syndrome]. Khirurgiya. Zhurnal im.N.I.Pirogova. 2019; (12): 132–136. DOI: 10.17116/hirurgia2019121132 (in Russian).

13. Chkhikvadze V.D., Kolesnikov P.G., Kovbasyuk D.A. [A rare case of torpid recurrent thymoma]. Onkologiya. Zhurnal im. P.A.Gertsena. 2019; 8 (1): 45–47. DOI: 10.17116/onkolog2019801145 (in Russian).

14. Ak N., Toker A., Kara M. et al. Outcomes of thymoma after multimodal therapy and determinants of survival: A 16-year experience of tertiary cancer center. Turk. J. Thorac. Cardiovasc. Surgery. 2021; 29 (4): 487–495. DOI: 10.5606/tgkdc.dergoso.2021/20529.

15. Wrona E., Debska-Szmich S., Pastuszka M. et al. Remission of thymoma on steroid therapy in a patient with atypical thymoma-associated multiorgan autoimmunity: a case report and literature review. Front. Immunol. 2021; 12: 584703. DOI: 10.3389/fimmu.2021.584703.

16. Sato J., Satouchi S., Itoh S. et al. Lenvatinib in patients with advanced or metastatic thymic carcinoma (REMORA): a multicenter, phase 2 trial. Lancet Oncol. 2020; 21 (6): 843–850. DOI: 10.1016/S1470-2045(20)30162-5.

17. Remon J., Girard N., Novello S. et al. PECATI: a multicentric, open-label, single-arm phase II study to evaluate the efficacy and safety of pembrolizumab and lenvatinib in pretreated B3-thymoma and thymic carcinoma patients. Clin. Lung Cancer. 2022; 23 (3): e243–246. DOI: 10.1016/j.cllc.2021.07.008.


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For citations:


Chichkova N.V., Kogan E.A., Fomin V.V., Parshin V.D., Fominykh E.V., Bychkov Yu.M., Morozova N.V., Ponomarev A.B. Diagnosis, combined treatment, and long-term follow-up of a thymoma patient. PULMONOLOGIYA. 2023;33(6):832-840. (In Russ.) https://doi.org/10.18093/0869-0189-2023-33-6-832-840

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ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)