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Type A thymoma with simultaneous solitary intrapulmonary metastasis: A case report
Tsutomu Tatematsu1, Katsuhiro Okuda1, Katsuhiko Endo2
1Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Thoracic Cancer
|May 7, 2021
Summary
A rare case of intrapulmonary thymoma metastasis was successfully treated with video-assisted thoracoscopic surgery (VATS). Complete resection achieved a favorable one-year outcome without recurrence.
Area of Science:
- Thoracic surgery
- Surgical oncology
- Pathology
Background:
- A 79-year-old woman presented with an abnormal chest shadow, leading to the discovery of a solitary lung nodule and an anterior mediastinal mass.
- Diagnostic imaging, including F18-fluorodeoxyglucose-positron emission tomography, identified these lesions, initially raising suspicion for primary lung cancer versus metastatic disease.
Observation:
- Video-assisted thoracoscopic surgery (VATS) revealed a carcinoid tumor intraoperatively.
- Subsequent histological examination of the resected lung nodule identified it as an intrapulmonary thymoma.
Findings:
- The final diagnosis was type A thymoma with intrapulmonary metastasis, classified as Masaoka stage IVb.
- Despite the advanced stage, complete surgical resection was achieved via VATS lobectomy and thymectomy.
- No additional adjuvant therapy was required post-operatively.
Implications:
- This case highlights the possibility of intrapulmonary metastasis from thymoma, even with an initial presentation mimicking primary lung cancer.
- Complete surgical resection, even in advanced stages, can lead to favorable outcomes for intrapulmonary thymoma.
- Minimally invasive approaches like VATS are effective for managing complex thoracic tumors, including thymoma with metastasis.
