Extended pleurectomy decortication for thymoma with pleural dissemination

Our plain-English summary of Extended pleurectomy decortication for thymoma with pleural dissemination, by N. Imanishi, Y. Nabe, M. Takenaka, et al (General Thoracic and Cardiovascular Surgery, 2019).

The study

• Authors: N. Imanishi, Y. Nabe, M. Takenaka, A. Hirai, Y. Ichiki, F. Tanaka
• Journal: General Thoracic and Cardiovascular Surgery
• Published: 2019;67(9):814-817
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Complete resection is the mainstay of treatment for thymoma. Even for advanced-stage thymoma with pleural dissemination, complete resection with extrapleural pneumonectomy may provide a favorable prognosis. Pleurectomy decortication, a lung-sparing surgery, has been preferably employed in recent years as an alternative surgical procedure for malignant pleural mesothelioma. However, little has been reported about pleurectomy decortication for other malignant tumors with pleural dissemination. Here, we present the first case of thymoma with pleural dissemination for which complete en bloc resection was achieved with extended pleurectomy decortication.

In plain English

This case report described one patient, a 30-year-old Japanese man with a type B1 thymoma (a tumor of the thymus) that had spread to the lining of the right chest cavity (pleural dissemination). The article does not discuss asbestos. Malignant pleural mesothelioma is mentioned only because the operation used, pleurectomy decortication, is a lung-sparing surgery employed for that disease. Surgeons removed in one piece the entire right pleura, the tumor and thymus, and involved parts of the pericardium, diaphragm, phrenic nerve and lung, while keeping the lung. Examination of the removed tissue showed tumor invasion into some parts of the lung and diaphragm. Recovery was uneventful, no further treatment was given, and the patient was alive without tumor recurrence one year after surgery. The authors called this the first confirmed case of its kind. They concluded that extended pleurectomy decortication may be one alternative treatment for this condition, noting that longer follow-up is needed to judge any survival benefit.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 30-year-old Japanese male patient with type B1 thymoma and pleural dissemination in the right chest, treated at the Hospital of the University of Occupational and Environmental Health, Japan; no nodal or distant metastasis
• Exposure: No asbestos or occupational exposure is reported. The intervention described was extended pleurectomy decortication, a lung-sparing surgery to remove the entire pleura, which has been used for malignant pleural mesothelioma.
• Main results:
  • Complete en bloc resection of the entire pleura and involved organs (diaphragm, pericardium, lung parenchyma, phrenic nerve) together with the thymus and thymoma was achieved in this patient
  • Pathology of the removed tissue showed tumor invasion into some parts of the lung parenchyma and diaphragm
  • The postoperative course was uneventful. The patient received no further treatment and was alive without tumor recurrence at 1 year after surgery.
• The authors' conclusion: The authors concluded that extended pleurectomy decortication may be one of the alternatives for treating thymoma with pleural dissemination.
• Limitations the authors state:
  • Follow-up was only 1 year; the authors state that longer follow-up is required to evaluate any survival benefit of extended pleurectomy decortication.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Extrapleural Pneumonectomy (EPP), Prognosis, Pleural Mesothelioma.

Related studies

• Non-incisional pleurectomy-decortication for malignant pleural mesothelioma — F. Tanaka, N. Imanishi, et al. (2018)
• A case of cardiac herniation after extrapleural pneumonectomy for malignant thymoma — S. Sonoda, Y. Kumagawa, et al. (2010)
• Thoracic shaping technique to avoid residual space after extended pleurectomy/decortication — S. Bölükbas, M. Eberlein, et al. (2013)
• Extrapleural pneumonectomy or pleurectomy/decortication for malignant pleural mesothelioma — S. Hasegawa (2014)
• Extended Pleurectomy and Decortication for Malignant Pleural Mesothelioma Is an Effective and Safe Cytoreductive Surgery in the Elderly — T. Williams, H. Duraid, et al. (2015)
• Current Treatment of Mesothelioma: Extrapleural Pneumonectomy Versus Pleurectomy/Decortication — A.S. Wolf, R.M. Flores (2016)

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