CORTICAL THYMOMA IN A CHILD : A RARE CASE REPORT

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D. A. G. S. D. K. D. S. S. S. D. D. L. Dr. Shubhada S. Aphale, “CORTICAL THYMOMA IN A CHILD : A RARE CASE REPORT”, ijmhs, vol. 3, no. 4, Oct. 2013.
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Abstract

Anterior mediastinal tumours can be very difficult to manage in peri-operative period more so in paediatric age group, literature provides cases of cardio-respiratory disasters and even death. We have come across a one year old female child who was apparently asymptomatic 6 months back, admitted in our hospital with complaints of cough, breathlessness, and increased work of breathing. Her past history revealed that she was misdiagnosed and treated repeatedly for pneumonia. This worsened her present pathology. On investigation, HRCT Thorax showed anterior mediastinal mass extending upto middle mediastinum and cranial aspect of heart. This child was posted for thoracotomy and excision of mediastinal mass. On pre-operative examination, child was febrile, anaemic, Respiratory rate was 52/min with decreased air entry on right side. Child was kept on regular nebulisation and continuous O2 supplementation. Administering anaesthesia to such a child was challenging as it requires an anticipation of respiratory and circulatory collapse. Presenting here this rare case, which we could manage with general anaesthesia supplemented with thoracic epidural anaesthesia. Complete surgical resection of tumour of size 16x8cm was possible with uneventful peri-operative course with effective post operative analgesia. Histopathology of tumour turned out to be cortical thymoma. Thymomas are neoplasms of anterior mediastinum and generally occur in adults. In children, they are rare with only 30-35 reported cases in literature.

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