Malignant Invasive Thymoma in the Posterior Mediastinum

doi:10.1016/j.athoracsur.2008.08.011

The Annals of Thoracic Surgery

Volume 87, Issue 4, April 2009, Pages 1274-1275

https://doi.org/10.1016/j.athoracsur.2008.08.011 Get rights and content

We present a rare case of malignant invasive thymoma (type A) arising from the posterior mediastinum. A 17-year-old girl was referred to our clinic after detection of a mass on a chest roentgenogram. Thoracoscopy showed a lobulated, pale yellowish mass located in the posterior compartment together with several foci in the lung parenchyma. The tumor and parenchymal foci were totally resected through a left minithoracotomy. Postoperative pathology revealed malignant invasive thymoma type A.

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A three-compartment model comprising an anterior-superior compartment, a visceral (middle) compartment, and the bilateral paravertebral sulci (posterior) is the most accurate anatomic representation of the mediastinum. Thymic lesions are most frequently observed in the anterior compartment [3]. Only 4% of thymomas are detected in the other compartments of the mediastinum and neck [4]. Embryologically, thymic epithelium arises bilaterally from the third and probably the fourth bronchial pouches

References (5)

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M. Kanzaki et al.
Noninvasive thymoma in the middle mediastinum
Ann Thorac Surg
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Cited by (5)

Ectopic primary intrathyroidal thymoma: A clinicopathological and immunohistochemical analysis of 3 cases
2016, Human Pathology
Citation Excerpt :
Ectopic thymomas are thought to arise from aberrant thymic tissue displaced during embryologic development and are extremely rare, accounting for only up to 4% of all thymomas [2]. Reported sites of ectopic thymoma include the neck, posterior and middle mediastinum, trachea, pericardium, lung, and pleural cavity, their distribution and frequency reflecting those of ectopic thymic tissue [3-9]. Another uncommon primary site of such tumors is the thyroid gland.
Thymomas are rare tumors that occasionally arise from ectopic locations. Ectopic thymomas originating within the thyroid gland are an exceedingly uncommon clinical entity that has only been described sporadically. In this study, we present the clinicopathological and immunohistochemical features of 3 primary intrathyroidal thymomas. The patients were 2 women and 1 man between the ages of 43 and 53 years (average, 48 years). Clinically, the patients presented with neck pain or enlarged thyroid glands. Physical examination and thyroid ultrasound revealed the presence of nodular masses confined to the thyroid parenchyma. No concurrent mediastinal tumors were identified in any of the cases, and none of the patients had a history of thymoma. Fine needle aspirate performed in 1 case was interpreted as possibly Hashimoto thyroiditis. Surgical resection was performed in all cases. Grossly, the lesions were circumscribed masses measuring from 1 to 4 cm in size. Histologically, the lesions showed the classic biphasic cellular proliferation of thymomas characterized by varying proportions of epithelial cells and lymphocytes. Two patients remain alive and well 1.5 to 2 years after their surgical resection, whereas the third patient was lost to follow-up. The cases herein presented highlight an unusual tumor entity that can be clinically confused for more common lesions affecting the thyroid gland. Awareness of this entity is important to avoid misdiagnosis and secure appropriate clinical management.
Thoracic neoplasms in children
2011, Radiologic Clinics of North America
Citation Excerpt :
Diffuse implants on pleural, mediastinal, and pericardial surfaces are seen with invasive thymoma; however, pleural effusion is uncommon.10 Thymomas may occasionally arise in locations other than the anterior mediastinum, including neck, elsewhere in the mediastinum, heart, or in the lung.8,12 Thymic carcinoma is a rare aggressive thymic neoplasm.
Imaging thymoma
2010, Journal of Thoracic Oncology
Thymoma is a rare tumor, although it is the most common primary neoplasm of the anterior mediastinum. In the majority of thymoma patients, imaging is requested for investigation of symptoms related to their tumor, although an increasing number of asymptomatic patients are discovered incidentally due to the increased utilization of computed tomography for screening or for imaging of other unrelated diseases. This review will focus on the goals of imaging thymoma, the imaging features of thymoma, as well as the advantages and limitations of each imaging modality in establishing the diagnosis, staging, and prognosis of thymoma.
The spectrum of ectopic thymomas
2016, Virchows Archiv
Unusual case of a stage i thymoma of the posterior mediastinum: Endoscopic ultrasound-guided fine needle aspiration alone clinches the diagnosis
2014, Endoscopy

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Case reportMalignant Invasive Thymoma in the Posterior Mediastinum

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J Thorac Cardiovasc Surg

Ann Thorac Surg

Case report
Malignant Invasive Thymoma in the Posterior Mediastinum