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Cardiomegaly Masquerading as a Pediatric Thymoma: A Case Report
Matthew R Figlewicz1, Rachel E Bridwell1, Hannah Beal2
1Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, USA.
Cureus
|November 26, 2020
Summary
Pediatric thymomas are rare, aggressive tumors often presenting with vague symptoms like shortness of breath. This case highlights a 16-year-old with advanced thymic neoplasm, emphasizing the need for early diagnosis.
Area of Science:
- Pediatric Oncology
- Thoracic Surgery
- Diagnostic Imaging
Background:
- Thymoma is an exceptionally rare pediatric mediastinal tumor, comprising less than 1% of cases.
- Pediatric thymomas exhibit a more aggressive behavior compared to adult counterparts, despite often being incidental findings.
Observation:
- Emergency department presentations are frequently subtle and non-specific, including dyspnea, cough, and chest pain.
- Diagnosis in children is often delayed due to non-specific symptoms, unlike in adults.
- Radiographic findings like an enlarged thymic shadow or cardiomegaly may necessitate cardiac evaluation.
Findings:
- A 16-year-old female presented with progressive dyspnea and chest pain.
- Imaging revealed cardiomegaly, leading to further investigation.
- The patient was diagnosed with a Masaoka stage III World Health Organization (WHO) type B3 thymic endothelial neoplasm.
Implications:
- Definitive diagnosis requires computed tomography and biopsy, underscoring the need for a multidisciplinary approach.
- Early recognition and diagnosis of pediatric thymoma are crucial for effective management.
- This case emphasizes the aggressive nature and diagnostic challenges of pediatric thymic neoplasms.
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