Mediastinal tumor resection in a patient with spinocerebellar degeneration

J Cardiothorac Surg. 2020 Jul 29;15(1):197. doi: 10.1186/s13019-020-01218-8.

Abstract

Background: In spinocerebellar degeneration (SCD) patients, general and regional anesthesia may cause postoperative dysfunction of respiratory, nerve and muscle systems. We present the surgical case of thymoma developed in patient with SCD.

Case presentation: A 47-year-old woman with spinocerebellar degeneration was admitted because of a well-defined mass measuring 48 × 31 mm in anterior mediastinum. She showed limb, truncal, ocular, and speech ataxia; hypotonia; areflexia; sensory disturbances; and muscle weakness. Her eastern cooperative oncology group performance status was 4. Surgical resection was performed via video-assisted thoracic surgery and under general anesthesia only without epidural analgesia. The mass was diagnosed as type B1 thymoma without capsular invasion (Masaoka stage I). The patients got a good postoperative course by cooperation with anesthesiologists and neurologists in perioperative managements. She has been well over 3 years of follow-up.

Conclusions: In conclusion, careful surgical and anesthesia management is essential for providing an uneventful postoperative course in patients with SCD. Especially, selection of minimal invasive approach and avoid diaphragmatic nerve damage are the most important points in surgical procedures.

Keywords: Mediastinal tumor; Spinocerebellar degeneration; Surgery.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Anesthesia, General / methods*
  • Anesthetics, Intravenous / therapeutic use
  • Female
  • Humans
  • Middle Aged
  • Neuromuscular Nondepolarizing Agents / therapeutic use
  • One-Lung Ventilation
  • Propofol / therapeutic use
  • Remifentanil / therapeutic use
  • Rocuronium / therapeutic use
  • Spinocerebellar Degenerations / complications*
  • Thoracic Surgery, Video-Assisted / methods*
  • Thymectomy / methods*
  • Thymoma / complications
  • Thymoma / diagnostic imaging
  • Thymoma / pathology
  • Thymoma / surgery*
  • Thymus Neoplasms / complications
  • Thymus Neoplasms / diagnostic imaging
  • Thymus Neoplasms / pathology
  • Thymus Neoplasms / surgery*

Substances

  • Analgesics, Opioid
  • Anesthetics, Intravenous
  • Neuromuscular Nondepolarizing Agents
  • Remifentanil
  • Rocuronium
  • Propofol