Type A thymoma: a rare cause of neoplastic cardiac tamponade with long-term survival

BMC Pulm Med. 2022 Jun 22;22(1):242. doi: 10.1186/s12890-022-02034-7.

Abstract

Background: The prognosis of thymoma with cardiac tamponade is generally poor. Most of the reported thymomas with cardiac tamponade were type B or type AB (mixed thymoma), and cardiac tamponade due to type A thymoma, which has a better prognosis compared to type B thymoma, is extremely rare.

Case presentation: We encountered a case of cardiac tamponade in a 71-year-old male. He visited our emergency department due to exacerbation of fatigue and dyspnea on exertion that lasted for two weeks. Chest imaging revealed a large amount of pericardial fluid and a contrast-enhanced tumor with calcification in the anterior mediastinum. The patient underwent thoracoscopic tumor biopsy and pathological examinations revealed type A thymoma. In this case, long-term disease-free survival (7.5 years) was achieved by multidisciplinary treatment (preoperative chemotherapy, surgical excision, and postoperative radiation therapy), in accordance with the histological type.

Conclusions: This case indicates that neoplastic cardiac tamponade, even in elderly patients, should not necessarily be regarded as a terminal cancer and requires a systematic investigation for underlying causes.

Keywords: Cardiac tamponade; Long-term survival; Multidisciplinary treatment; Type A thymoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cardiac Tamponade* / etiology
  • Humans
  • Male
  • Mediastinum / pathology
  • Pericardial Effusion* / etiology
  • Thymoma* / complications
  • Thymoma* / pathology
  • Thymoma* / therapy
  • Thymus Neoplasms* / complications
  • Thymus Neoplasms* / diagnosis
  • Thymus Neoplasms* / therapy