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

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A study conducted by researchers in Norway explored the use of preoperative steroid pulse therapy in the treatment of invasive thymoma. Thymomas, a type of tumor originating in the thymus gland, have shown positive responses to high-dose glucocorticoid treatment in previous studies. However, corticosteroids are rarely mentioned in international treatment guidelines for thymomas. <br /><br />The researchers treated a woman in her 50s with stage III thymoma, suspected to have invaded the pericardium, aorta, and chest wall. The multidisciplinary team determined the case to be borderline resectable and suggested neoadjuvant treatment with glucocorticoids. <br /><br />The patient underwent a CT-guided biopsy, which confirmed the presence of a thymoma without further classification. Due to the risks associated with surgery, the patient received neoadjuvant treatment with pulse doses of Solu-Medrol, an intravenous glucocorticoid, for five days every second week for three cycles. <br /><br />After the neoadjuvant treatment, the tumor volume significantly reduced from 61 cm3 to 16 cm3. Twelve days after the last Solu-Medrol dose, the patient underwent thymomectomy. Microscopic examination of the tumor revealed it to be type B2 with pronounced necrosis except for the central part, which consisted of viable tissue. No infiltration was detected in the adherent pericardium or lung tissue. <br /><br />The researchers concluded that neoadjuvant treatment with glucocorticoids had a considerable effect on reducing the size of the thymoma in their patient. This shrinkage made the surgical removal of the tumor easier and less invasive for the patient, as it required intracostal surgical access instead of sternotomy. Additionally, the researchers believed that the neoadjuvant treatment reduced the risk of perioperative metastases. This study suggests that preoperative steroid pulse therapy could be a beneficial approach for the treatment of invasive thymomas.

Asset Subtitle

Janna Berg

Meta Tag

Speaker Janna Berg

Topic Thymic Malignancy

Keywords

preoperative steroid pulse therapy

invasive thymoma

tumor

thymus gland

high-dose glucocorticoid treatment

neoadjuvant treatment

glucocorticoids

Solu-Medrol

thymomectomy

perioperative metastases