Surgical Treatment of Thymoma

흉선종의 수술치료

  • 홍치욱 (경희대하교 의과대학 흉부외과학교실) ;
  • 박주철 (경희대하교 의과대학 흉부외과학교실)
  • Published : 1997.01.01

Abstract

Between January 1986 and December 1995, 24 patients were treated surgically for thymoma. There were 17 males and 7 females, and their ages ranged from 23 to 69 years old and mean age was 49 years. Thymomas ere associated with fourteen myasthenia gravid, and classified histologically as Iymphocytic in 12 patients, mixed in 8, epithelial in 4, and classified clinically as stage I in 11, stage II in 4, stage III in 8 and stage VI in 1 patient. Eleven patients with non-invasive thymoma had received surgical resection, and 10 out of 13 patients with invasive thymoma were able to undergo complete resection. A partial resection or tissue biopsy followed by radiation or chemotherapy was done with the remaining three patients. Three died, four had improvement of symptom, two had relapse and fifteen had no symptom during follow up ranged from 25 days to 60 months. In fourteen cases of thymoma with myasthenia gravid, one died due to myasthenic crisis, two showed symptom aggravation, six had less medical treatment and five patients had medical treatment as same as dosage received preoperatively.

1986년 1월부터 1995년 12월까지 24예의 흉선종에 대한 수술적 치료를 시행하였다. 대상환자들은 남자 17명, 여자 7명이었으며, 연령은 23세 에서 69세 사이였다. 중증근무력증은 14예에서 동반되 있다. 조직학적 분류로 임파구성 12예,흔합형 8예,상피세포형 4예를 보였고, 병기학적 분류로 I기 11예, II기 4 예, III기 8예였고 VI기는 1예 있었다. 11예의 비침윤형은 모두 외과적 절제를 하였고, 침윤형 13예중 10예에서 완전절제가 가능하였고, 나머지 3예는 부분절제 또는 조직생검후 방사선치료 및 항암화학요법을 시행하였다. 25일에서 60개월의 추적 조사기간중 사망이 3예 있었고, 경과의 호전 4예, 재발 2예 및 15예의 완쾌를 관찰하였다. 근무력증을 동반한 흉선종 환자 14예중 1예가 근무력위기로 사망하였고, 2예가 증상악화, 6예가 약 용량을 감소 또는 복용을 중지하였으며 5예는 술전과 비슷한 용량의 약물치료가 필요하였다

Keywords

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