Gland surgery · 2026
Multidisciplinary minimally invasive planning for synchronous breast cancer and thymoma: a scarless single-stage surgical strategy-a case report and literature review.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Pelle Fabio, Barbaria Cecilia, Cappelli Sonia, Barba Maddalena, Ferretti Gianluigi, Gallina Filippo Tommaso, Pozzi Marcello, Facciolo Franco, Melis Enrico, Mercadante Edoardo, Botti Claudio
Аннотация
BACKGROUND: Synchronous breast cancer and thymoma are uncommon clinical scenarios and are traditionally treated with phased surgery, often requiring separate operative sessions and potentially delaying comprehensive oncologic management. Although minimally invasive surgery enables single-stage approaches, the role of surgical planning in coordinating multidisciplinary procedures remains underreported.
CASE DESCRIPTION: We report the case of a 40-year-old woman who had synchronous thymoma and HER2-positive breast cancer. After multidisciplinary evaluation, a single-stage surgical strategy was planned, combining robotic extended thymectomy, bilateral nipple-sparing mastectomy, axillary lymph node dissection and immediate reconstruction. The novelty of this report lies in the planning-driven strategy that guided procedural sequencing, access selection, and incision placement, with the explicit aim of preserving oncologic radicality while minimizing surgical footprint. Robotic thymectomy was performed first through a left-sided approach, with subxiphoid specimen extraction to avoid interference with breast incisions. Breast surgery and reconstruction were then carried out using scar-sparing approaches. Postoperative recovery was uneventful, with complete pathological response of breast cancer, R0 thymoma resection, and excellent aesthetic outcome.
CONCLUSIONS: This case demonstrates that combined chest surgery should be considered primarily a planning challenge rather than only a technical challenge. Careful preoperative coordination among thoracic surgeons, breast surgeons and reconstructive teams plays a key role in defining operative priorities, minimizing surgical conflict, and achieving optimal oncologic and aesthetic outcomes. This experience supports the feasibility of a personalized single-stage approach in selected patients undergoing simultaneous treatment of thoracic and breast malignancies.
CASE DESCRIPTION: We report the case of a 40-year-old woman who had synchronous thymoma and HER2-positive breast cancer. After multidisciplinary evaluation, a single-stage surgical strategy was planned, combining robotic extended thymectomy, bilateral nipple-sparing mastectomy, axillary lymph node dissection and immediate reconstruction. The novelty of this report lies in the planning-driven strategy that guided procedural sequencing, access selection, and incision placement, with the explicit aim of preserving oncologic radicality while minimizing surgical footprint. Robotic thymectomy was performed first through a left-sided approach, with subxiphoid specimen extraction to avoid interference with breast incisions. Breast surgery and reconstruction were then carried out using scar-sparing approaches. Postoperative recovery was uneventful, with complete pathological response of breast cancer, R0 thymoma resection, and excellent aesthetic outcome.
CONCLUSIONS: This case demonstrates that combined chest surgery should be considered primarily a planning challenge rather than only a technical challenge. Careful preoperative coordination among thoracic surgeons, breast surgeons and reconstructive teams plays a key role in defining operative priorities, minimizing surgical conflict, and achieving optimal oncologic and aesthetic outcomes. This experience supports the feasibility of a personalized single-stage approach in selected patients undergoing simultaneous treatment of thoracic and breast malignancies.