الفهرس 
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Abstract
The thymus gland is a bilobed lymphoid organ located in the anterior compartment of the mediastinum, it consists of stroma and parenchyma. Thymic enlargement may be due to thymic neoplasms (which include thymoma, thymic carcinoma and neuroendocrine tumor) and thymic cysts and thymic hyperplasia. Thymomas are the most common neoplasms of thymic masses which account for about 50% of anterior mediastinal masses and 15% of all mediastinal tumors. Thymic carcinoma are rare thymic tumors. However, neuroendocrine tumors are very rare tumors. In this study, we have operated upon 48 cases for thymic masses which included 33 (68.8%) case of thymic hyperplasia, 12(25.0%) cases of thymoma stage II, one (2.1%) case of non Hodjkins’ lymphoma, one (2.1%) case of thymolipoma and the other case (2.1%) of fibrosing mediastinitis. The mean age of our patients was 27.94 year. Males constituted 41.7 % of patients. The most common presentation was myasthenic symptoms. Chest X rays revealed mediastinal abnormalities in 77.1 % of the patients and CT chest showed anterior mediastinal mass in all of them. Standard median sternotomy was the most common approach for thymectomy in 44 (92 %) patients. Two (40%) patients were operated upon through partial sternotomy and the other two (40%) cases were operated upon through right anterolaterl thoractomoy. The mean postoperative ventilation time in our study was 10.13 hour , the mean postoperative I.C.U stay was 3.10 days while the mean inhospital stay was 4.14 days. Thirteen malignant cases received postoperative neoadjuvant chemotherapy and/or radiotherapy. As regard the outcome of surgery, there was 28 (58.33%) case who were considered as excellent results which mean complete remission of the preoperative symptoms and marked improvement after surgery. The other group which were considered as satisfactory results 20 (41.66%) patients were defined as patients who improved and those who were still unchanged. The mean follow up in this study was 30.02 month. From this study, we conclude that thymic masses are rare but life threatening, especially if there is associated myasthenia gravis for which thymectomy had been proved to be very beneficial in ameliorating the symptoms and stopping the progress of the disease. Thymectomy should be performed as soon as the patient is diagnosed, and the maximal thymectomy with opening of both pleurae improves the results. Standard diagnostic facilities (Chest X ray, CT chest , EMG and good neurological examination) are enough to establish the final diagnosis. We also conclude that neither age , sex nor duration of symptoms can be considered as predictors of outcome in thymectomy for thymic masses, however, the thymic pathology is considered as a potentially predictor for it. We also conclude that the finding of thymic mass in a patient with myasthenia gravis is highly suggestive of thymoma. And In malignant cases thymectomy plus multimodality treatment with neoadjuvant chemotherapy and/or radiotherapy improve the results.