Effect on Coronary Circulation

particularly in cases of invasive thymoma where complete resection is technically difficult and hazardous, as in our patient. Hence, chemotherapy was administered and followed up with radiotherapy. The chemotherapeutic regimen used in this patient is considered the current standard and was initiated after normal cardiac function was restored. The increased risk of cardiomyopathy in patients with myotonic dystrophy makes the use of potentially cardiotoxic drugs debatable, but the benefits in this case were believed to outweigh the risks. To further reduce cardiotoxicity, doxorubicin was administered as a continuous infusion over 4 days rather than as a bolus. A PET scan performed at the completion of all therapy showed no evidence of thymoma despite the presence of a residual mass (presumably fibrous tissue) measuring 2 3c m on CT scan that has remained stable over 6 months. Thymoma is best treated by complete surgical resection when feasible. Noninvasive thymoma (Masaoka stage I) is completely resected with a recurrence rate of only 1.5%. No adjuvant therapy is required. Invasive or malignant thymoma (Masaoka stages II, III, and IV) is more difficult to treat. Surgery is still the mainstay with total resection where possible. Radiotherapy and chemotherapy are very useful