Journal of Cardiothoracic Surgery (Dec 2022)

Usefulness of intraoperative nerve monitoring for giant type AB thymoma combined with an aberrant right subclavian artery: a case report

  • Yoshihito Iijima,
  • Masahito Ishikawa,
  • Shun Iwai,
  • Aika Yamagata,
  • Nozomu Motono,
  • Hiroyuki Tsuji,
  • Hidetaka Uramoto

DOI
https://doi.org/10.1186/s13019-022-02056-6
Journal volume & issue
Vol. 17, no. 1
pp. 1 – 7

Abstract

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Abstract Background Abnormal tumor vascularization and escalating tumor size represent two major impediments that make cancer surgery impossible or complicated. Case presentation Herein, we report the case of a giant thymoma (type AB) in a 58-year-old woman who presented with cough and yellow sputum. The thymoma grew extensively from the neck to the upper mediastinum. The patient exhibited an aberrant right subclavian artery and a non-recurrent inferior laryngeal nerve. Intraoperative nerve monitoring facilitated the identification and preservation of vital nerves spanning the neck and chest, including the non-recurrent inferior laryngeal nerve. Furthermore, the tumor was divided naturally along the constriction, and a good field of view was acquired to identify abnormal right subclavian arteries and nerves that ran deep in the tumor and surgical field. The tumor was safely removed without complications using intraoperative nerve monitoring, and the thymoma that grew extensively from the neck to the upper mediastinum and was associated with an aberrant right subclavian artery was resected. Conclusion Intraoperative nerve monitoring was helpful in identifying the non-recurrent inferior laryngeal nerve and left recurrent laryngeal nerve.

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