手术治疗巨大胸腺瘤伴重症肌无力1例报告

Surgical treatment of giant thymoma in a patient with myasthenia gravis

报道一例伴有重症肌无力的巨大胸腺瘤(切除后测量为17 cm×14 cm×4 cm)的青年男性患者,检查示肿瘤侵犯纵膈内血管、心包等组织,病理分型A型,Masaoka分期Ⅲ期。予以胸骨正中切口成功手术切除胸腺瘤,患者术后出现重症肌无力危象等严重并发症,予以气管切开等处理后,成功治愈出院,共使用呼吸机102 d,住院252 d,目前随访6年余,患者生活质量良好且育有一子。该个案提示,对于伴有重症肌无力的胸腺瘤患者,应该采取以手术切除为主的综合治疗。

We report a case report of giant thymoma （17 cm×14 cm×4 cm） in a 32-year-old male patient with myasthenia gravis.Examinations revealed that the tumor invaded the mediastinum,blood vessels and pericardium,and was histologically classified as WHO type B1 and Masaoka stage III.The patient developed myasthenia gravis crisis after radical resection of the thymoma and appropriate treatments with tracheotomy were administered.The patient recovered and was discharged after a hospital stay for 252 days with a mechanical ventilation time of 102 days.