RESUMO
Interrupted inferior vena cava (IVC) is a rare developmental defect characterised by azygos continuation following failure of fusion of one or more of the component parts of the embryological IVC and occurring in approximately one in 5000 of the general population. It is usually an isolated finding and generally asymptomatic. We present a case of non-small cell lung cancer requiring right pneumonectomy in a patient with an interrupted IVC with azygos continuation.
Assuntos
Veia Ázigos/anormalidades , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/cirurgia , Pneumonectomia/efeitos adversos , Toracotomia/efeitos adversos , Malformações Vasculares/complicações , Veia Cava Inferior/anormalidades , Idoso , Veia Ázigos/diagnóstico por imagem , Veia Ázigos/patologia , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/patologia , Quimioterapia Adjuvante , Feminino , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Invasividade Neoplásica , Estadiamento de Neoplasias , Flebografia/métodos , Radioterapia Adjuvante , Fatores de Risco , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Malformações Vasculares/diagnóstico por imagem , Veia Cava Inferior/diagnóstico por imagemRESUMO
The optimal treatment for Masaoka stage IVA thymoma remains controversial. Whilst extrapleural pneumonectomy (EPP) has been proposed, we sought to examine the results of our institutional preference for induction chemotherapy, cytoreductive surgery and intraoperative hyperthermic pleural irrigation. We undertook a retrospective study of patients undergoing surgery for Masaoka stage IVA thymoma following induction chemotherapy over a three-year period at our institution. Between February 2007 and February 2010, 42 patients underwent surgery for thymoma. Six patients underwent surgery with intent to perform cytoreductive surgery and intraoperative hyperthermic pleural irrigation. Complete cytoreductive surgery was not feasible in one patient and thymectomy only was performed. One patient had re-operation for recurrent disease 24 months after the first operation and there were therefore seven procedures undertaken in six patients during the study period. There were no in-hospital deaths. Median follow-up was 18.8 months (range 1.5-31.9 months). One patient died 14 months postoperatively from an acute cardiovascular event. The four remaining patients are alive and well with no evidence of disease recurrence. Multimodality therapy consisting of induction chemotherapy and cytoreductive surgery is a safe, feasible treatment for stage IVA thymoma. Our experience suggest that full pleurectomy is an alternative to EPP.