Author(s): Nawojowska, Ágata ; Cabral, Daniel ; Neves, José ; Félix, Francisco
Date: 2025
Origin: Portuguese Journal of Cardiac Thoracic and Vascular Surgery
Subject(s): case report; invasive thymic squamous cell carcinoma; intraauricular mass; cardiopulmonary bypass support; superior vena cava resection
Introduction: Complete radical resection is crucial for successfully treating thymic carcinomas. However, when the invasion of the great vessels or the heart in Masaoka III and IV stages occurs, the management poses more challenges. The R0 resection often requires neoadjuvant treatment. We present an example of a debatable case in which a treatment decision was guided by an imminent risk to the patient's life. Case description: We report the case of a 74-year-old female with a mediastinal mass invading the superior vena cava (SVC) and the right atrium (RA), which was successfully treated with radical resection. The procedure under the femoro-femoral CardioPulmonary Bypass (CPB) included resection of the right intra-auricular mass and the SVC followed by the interposition of a Gore-Tex conduit between the left innominate vein and RA and also wedge resection of the upper left (LUL) and right lobes (RUL). A final histopathological examination confirmed the diagnosis of squamous cell carcinoma. Conclusions: Complete radical resection is essential for successful treatment and represents the most significant prognostic factor.
