Malignant thymoma (thymic carcinoma)

Case contributed by Dr Roberto Schubert

Presentation

Cough, chest pain, dyspnea, and weight loss.

Patient Data

Age: 75 years
Gender: Female

Radioopaque mass in the left anterior and middle mediastinum. Left pleural effusion and high-riding diaphragm suggesting phrenic nerve palsy

An anterior mediastinal mass demonstrates polycyclic contours and bulges out against the anterior segment of the left lung. This mass heterogeneous enhances with intravenous contrast. Large left pleural, right effusion within the fissure, and small pericardial effusions present.

Case Discussion

At bronchoscopy, a tumor invasion of the left S3 bronchus was found. Biopsy specimens were classified as thymic carcinoma (WHO type C). The extent of the disease was attributed to stage IV according to the Masaoka system 1.

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