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Ann Thorac Surg 2007;83:1526-1528
© 2007 The Society of Thoracic Surgeons

Case Reports

Shock Induced by Spontaneous Rupture of a Giant Thymoma

Stefano Santoprete, MD, Mark Ragusa, MD, FCCP, Moira Urbani, MD, Francesco Puma, MD*

Department of Thoracic Surgery, University of Perugia, Medical School, Terni, Italy

Accepted for publication October 4, 2006.

* Address correspondence to Dr Puma, Chirurgia Toracica, Ospedale Civile S. Maria, Terni, 05100 Italy (Email: francescopuma{at}aospterni.it).

Spontaneous bleeding of thymoma is a very rare event. We report the case of a 73-year-old woman who was referred to our hospital for acute onset of chest pain followed by shock. Chest computed tomographic scanning showed a huge mediastinal tumor with abundant left pleural effusion and contralateral shift of the mediastinum. Emergency surgical treatment was carried out through a clamshell incision. At the opening of the left pleura 1,600 mL of fresh blood was found, originating from a rupture of the tumor’s capsular veins. The lesion was completely resected, en-bloc with a wide pericardial excision. The postoperative course was uneventful. The pathology report classified the lesion as thymoma AB.




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