Invasive thymoma presenting as aortic dissection

We report the case of an invasive thymoma presenting as an aortic dissection in a 49-year-old woman with hypertension and a marfanoid appearance. The patient presented to the emergency department with "tearing" substernal chest pain. A chest radiograph revealed a right para-aortic bulge consistent with a dissecting aorta, but an aortogram was normal. Other disease states, including various types of mediastinal masses, have been reported to mimic aortic dissection.