PMC8474406_01
Diagnostic CT images before the surgery. (A) Axial view of CT (white arrow, thymic carcinoma). (B) Axial view of CT revealing the graft and anastomotic region (white arrow). (C) Reconstructed image of CT (green object, thymic carcinoma on the outflow graft of the LVAD; white arrow, the anastomotic region between the outflow graft and ascending aorta). CT, computed tomography; LVAD, left ventricular assist device.
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During follow-up, he was diagnosed with a thymus tumor on the outflow graft of the LVAD by computed tomography (CT) (Fig. 1A-C).
Dose distribution of PORT in (A) axial view and (B) coronal view. PORT, postoperative radiotherapy.
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A total dose of 66 Gy in 33 fractions with 6-MV photons was administered: 50 Gy in 25 fractions for the tumor bed and an additional 16 Gy in eight fractions at the surgical margin (Fig. 2A and B).
Follow-up CT images at 13 months after the initiation of PORT. (A) No evidence of cancer recurrence was observed. A soft tissue mass can be noted in the tumor bed. This mass revealed no change in size from immediately after the surgery until this CT, leading to its diagnosis as a postoperative scar. (B) No significant change was noted around the graft or anastomotic region. CT, computed tomography; PORT, postoperative radiotherapy.
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In the 13-month follow-up period, no evidence of cancer recurrence and no radiological change in the graft or anastomotic region were observed (Fig. 3A and B).