2023 World Conference on Lung Cancer (Posters)-EP14.02. Preoperative Steroid Pulse Therapy for Invasive Thymoma

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This case report discusses the use of preoperative steroid pulse therapy in a woman with invasive thymoma. Thymomas are rare tumors located in the thymus, and high-dose glucocorticoids have been shown to have therapeutic effects on these tumors. However, corticosteroids are rarely mentioned in international guidelines for thymoma treatment. <br /><br />The patient in this case had a diagnosis of stage III thymoma with suspected invasion of the pericardium, aorta, and chest wall. Due to the high risk of surgery, she received neoadjuvant treatment with glucocorticoids. Specifically, she received a pulse dose of Solu-Medrol intravenously for five days every two weeks for three cycles. <br /><br />The treatment resulted in a reduction in thymoma volume from 61 to less than 16 cm3 preoperatively. However, there were still contact areas between the tumor and surrounding structures. The patient underwent thymomectomy, with no ingrowth into the pericardium or large vessels. Microscopic examination of the tumor showed pronounced necrosis, with viable tissue only in the central part of the tumor.<br /><br />The neoadjuvant treatment had a significant effect on tumor reduction, making surgical removal easier and reducing the risk of perioperative metastases. The use of intracostal surgical access instead of sternotomy was also more gentle for the patient. It is important to note that the contact areas between the tumor and other mediastinal structures are typically the last to disappear. <br /><br />In conclusion, the use of preoperative steroid pulse therapy had a valuable impact on thymoma reduction in this patient. This approach may offer benefits such as easier surgical removal and reduced perioperative metastasis risk.

Asset Subtitle

Janna Berg

Meta Tag

Speaker Janna Berg

Topic Thymic Malignancy

Keywords

preoperative steroid pulse therapy

invasive thymoma

thymomas

high-dose glucocorticoids

international guidelines

neoadjuvant treatment

Sol-Medrol

thymomectomy

perioperative metastases

intracostal surgical access