Coexistence of thymoma and necrotizing pneumonia: a case report with a fatal outcome
DOI:
https://doi.org/10.18203/2349-2902.isj20213613Keywords:
Thymoma, Necrotizing pneumonia, Epithelial tumors of the thymusAbstract
Thymoma is an entity with an estimated incidence of 1.2-3.2 per million people, with a prognosis and treatment determined by its clinical stage and histological classification, the most widely used classification systems being the Masaoka-Koga for clinical stage and that of the world health organization (WHO) for histology. Necrotizing pneumonia is another rare entity that was initially described in adults in the 1940s; however, it is currently being studied more extensively in the pediatric setting, and currently its treatment, especially in adults, is unclear and surgical treatment usually reserved in the presence of complications and poor response to medical management. The coexistence of two rare entities is a problem for which therapeutic options are limited; the general condition of the patient is a determining factor in the outcome in a critically ill patient. In the present case, the association of two infrequent entities is reported, which presented a pneumothorax as a complication that required placement of an endo-pleural tube for drainage, pre-surgical biopsy a B1 thymoma was reported. The post-surgery pathology report was an encapsulated thymoma, WHO type A, the broad-spectrum antibiotic management did not prevent the dissemination of the septic focus in the context of a patient with malnutrition and immunosuppression.
References
Rioja P, Ruiz R, Galvez‐Nino M, Lozano S, Valdiviezo N, Olivera M et al. Epidemiology of thymic epithelial tumors: 22‐years experience from a single‐institution. Thorac Cancer. 2021;12(4):420-5.
Benveniste MFK, Betancourt Cuellar SL, Carter BW, Strange CD, Marom EM. Thymic Epithelial Neoplasms. Radiol Clin North Am. 2021;59(2):183-92.
Huang J, Detterbeck FC, Wang Z, Loehrer PJ. Standard outcome measures for thymic malignancies. Zhongguo Fei Ai Za Zhi. 2014;17(2):122-9.
Scorsetti M, Leo F, Trama A, D’Angelillo R, Serpico D, Macerelli M et al. Thymoma and thymic carcinomas. Crit Rev Oncol Hematol. 2016;99:332-50.
Krutikov M, Rahman A, Tiberi S. Necrotizing pneumonia (aetiology, clinical features and management). Curr Opin Pulm Med. 2019;25(3):225-32.
Seo H, Cha S-I, Shin K-M, Lim J-K, Yoo S-S, Lee J et al. Clinical relevance of necrotizing change in patients with community-acquired pneumonia. Respirology. 2017;22(3):551-8.
Bover-Bauza C, Osona B, Gil JA, Peña-Zarza JA, Figuerola J. Resultados a largo plazo de la neumonía necrotizante. An Pediatría. 2020;S1695-4033(20)30292-7.
Reimel BA, Krishnadasen B, Cuschieri J, Klein MB, Gross J, Karmy-Jones R. Surgical Management of Acute Necrotizing Lung Infections. Can Respir J. 2006;13(7):369-73.