A case of cardiac tamponade shock due to bleeding from an advanced thymoma

Abstract

Although thymomas are the most common anterior mediastinal neoplasm, those causing cardiac tamponade are unusual. To the best of our knowledge, only 13 cases have been proven in the English literature We report thymoma in a 66-year old man that caused cardiac tamponade, for which he underwent an emergency operation. On admission, he presented in a shocked state; his echocardiography results revealed pericardial effusion. Computed tomography scan indicated a thymoma infiltrating the right lung. Initially, pericardial drainage was performed through puncture; however, cardiac tamponade recurred next day. Pericardial drainage, thymectomy, and pericardiectomy were performed, but the tumor was incompletely resected. On postoperative day 2, right upper lobectomy was attempted but discontinued because of the impossibility to manipulate the pulmonary hilum, which was suspected to have tumor infiltration. He was discharged on the 27th day after the first operation, is alive at 10 months after surgery, and is under chemotherapy.