I’m a 36 yo male, active duty in US military, w/ hx of Ollier’s Diesease and low-grade chondrocoma (excised 6 yr ago). Recently another suspected low-grade chondrocoma was identified in my scapula for which they planed a partial resection.
On studying the scapula, they found pulmonary nodules and a 2.5 x 4.5cm enhancing mediastinal mass, which demonstrated hypermetobolic activity on PEC/CT scan.
Based on normal blood work (chem./CBC, and negative tumor markers) the fact that I’m not sick or have any suspicious signs or symptoms they are calling this is a stage 1 thymoma which they plan to excise. This surgery usurps the partial scapula resection.
Interventional radiologist have declined the opportunity for percutanious biopsy and thus I’m scheduled for en bloc radical thymectomy via medium sternotomy w/o prior bx.
At this point, since I feel fine, the idea of all this surgery is like knowing stepping in front of a bus. I’m going to go through with it but would feel better if I could find anything that would lead me to a less painful recovery.
Chondrocoma and thymoma are rare – anyone ever heard of an association? I’m unable to find anything in the medical literature. Given my hx, are there other more likely enhancing mediastinal masses that should be considered?
The bulk of the literature seems to support medium sternotomy for radical en bloc thymectomy . In my search I find the literature demonstrates that VATS or RATS is technically achievable, however there does not seem to be enough evidence to establish superiority over the more invasive approach. As long as I’m going through this I want to go with the best evidence. Anyone know of a RCT or other long term data that supports the minimally invasive approaches? I’m going to feel foolish if I go through all this pain only to find that my procedure is out dated.
The sternal wires are concerning to me. Not only will I be frequently followed with MRI for the various tumors related to my Ollier’s disease but I imagine someone will be interested in following my pulmonary tumors too. Are there concerns with artifacts from the sternal wires? Do they make a nonferromagnetic sternal closure devise that might be better in my case. As the magnets in the MRI’s get bigger, will I experience pain or discomfort from these wires in the MRI?