Thymectomy and transpericardial nodal dissection.

Area of Science:

• Oncology
• Thoracic Surgery
• Neurosurgery

Background:

• Neuroendocrine thymic tumors (NETTs) are rare neoplasms.
• Surgical resection of the tumor and involved lymph nodes is the primary treatment.
• Optimal surgical strategy for NETTs requires individualized approaches based on tumor location.

Purpose of the Study:

• To describe a specific surgical technique for a patient diagnosed with a thymic malignant tumor and subcarinal nodal involvement.
• To emphasize the importance of a tailored surgical approach in managing NETTs.
• To demonstrate a successful surgical and oncological outcome for a complex NETT case.

Main Methods:

• Median sternotomy for extended thymectomy.
• Transpericardial approach for mediastinal lymph node dissection (stations #2R, #4R, #4L, #5, #7).
• Individualized surgical technique based on tumor location and nodal involvement.

Main Results:

• Definitive pathology confirmed a NETT without nodal involvement.
• The patient remained disease-free 19 months post-surgery.
• The described surgical technique yielded good technical and oncological results.

Conclusions:

• Complete surgical excision combined with adjuvant therapy provides the best prognosis for NETTs.
• Individualized surgical techniques are crucial for optimizing outcomes in NETT management.
• Thoracic surgeons should be proficient in advanced techniques for NETT resection.