Treatment of thymoma with low-dose glucocorticoids before surgery for significant tumor shrinkage: A case report.

Abstract

Background: Thymic epithelial neoplasms are rare malignant neoplasms originating in the thymus gland. There have been case reports of patients with advanced thymomas treated with a methylprednisolone pulse or with glucocorticoid (GCs) shock before surgery, followed by surgical treatment, all of whom achieved good results. The effect of GCs on thymomas is related mainly to the action on GC receptors in thymic lymphocytes and epithelial cells. GC receptor expression has been associated with a better prognosis in patients with thymomas, including those with surgically removed thymomas.

Case summary: We report a case of a patient with thymoma who had a significant response to preoperative low-dose GC therapy. A mediastinal tumor was detected in the patient via computerized tomography upon admission. The tumor was initially suspected to be a thymic tumor, but lymphoma could not be ruled out. The tumor shrank significantly after low-dose (5 mg/day) GC therapy. Thoracoscopic thymoma resection was performed after puncture pathology was confirmed. The patient recovered well after the operation and is currently performing well with no recurrence of the tumor.

Conclusion: This case highlights that low-dose GCs are effective in the treatment of thymomas, and we believe that GCs should be applied more frequently and studied more thoroughly in the treatment of thymomas.