Thymic squamous cell carcinoma with multiple brain metastases

Thymic carcinomas are rare epithelial malignancies with marked invasive tendency which can metastasize to distant organs, most commonly to the lung, bone, liver, kidney and extra-thoracic lymph nodes. Central nervous system metastasis is extremely rare and only 45 such cases have been reported in the English literature. We reported a 42-year-old male with thymic squamous cell carcinoma and lung and bones metastases. He underwent thymomectomy and pulmonary lobectomy with concurrent chemo-radiotherapy. Based on the clinical symptoms of severe headache and vomiting and the results of brain computed tomography and magnetic resonance imaging scans, 2 metastatic tumors with a cystic component were diagnosed. We resected the metastatic tumors and the signs of increased intracranial pressure subsided immediately after the operation. The patient underwent continuous chemotherapy systemically and whole brain irradiation for disease control. This presentation suggests that surgical resection with concurrent chemo-radiotherapy is the treatment of choice for thymic carcinomas with brain metastases.