Thoracoscopic Thymectomy with Tangential Partial Resection of the Innominate Vein

We herein report a case in which thoracoscopic thymectomy with partial resection of the brachiocephalic vein was performed using a subxiphoid approach. We suggest the usefulness of the subxiphoid approach in thymectomy. We could extend the indications of thoracoscopic thymectomy for invasive tumors. Thoracoscopic thymectomy with the combined resection of part of the brachiocephalic vein was possible. The pathological diagnosis of the tumor was diffuse large cell B-cell lymphoma. Since the postoperative complications were minimal, postoperative adjuvant chemotherapy could be initiated without delay. This operation might be unnecessary. However, we could decrease the invasiveness of surgery using our procedures without sternotomy. Thoracoscopic thymectomy using subxiphid approach seems to be an ideal procedure for the surgical treatment of invasive lesions.