Thymomaptysis: unusual presentation of invasive thymoma

Symptomatic thymomas are characterized by non-specific thoracic symptoms or symptoms related to associated para-thymic syndromes. We report the case of a 56-year old Caucasian male who was affected by invasive (Masaoka IVA) WHO mixed AB-B2 thymoma after the elimination through the sputum of a fragment of tumour vegetating in the left upper lobar bronchus. The patient received multimodal treatment consisting of neoadjuvant cisplatinum-based polychemiotherapy, radical surgical resection ('en bloc' thymectomy, thymomectomy and pulmonary left upper lobe exeresis and pleural implants resection) and subsequent mediastinal radiation therapy. At 18-month follow-up, the patient is alive and disease-free.