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Small-sized type A thymoma with pulmonary metastasis: a case report
Sachi Kawagishi1, Tomohiro Maniwa2, Hirokazu Watari2
1Department of General Thoracic Surgery, Osaka International Cancer Institute, 1,3,4: 3-1-69, Otemae, Chuo-ku, Osaka, 541-8567, Japan. sachi.kawagishi@oici.jp.
Surgical Case Reports
|January 20, 2022
Summary
This study reports the first case of a small type A thymoma (12 mm) metastasizing to the lung. It highlights the importance of considering pulmonary metastasis from type A thymoma, regardless of tumor size.
Area of Science:
- Oncology
- Thoracic Surgery
- Pathology
Background:
- Type A thymomas are typically benign, slow-growing tumors of the thymus.
- They rarely metastasize, especially when smaller than 20 mm.
- Previous reports of metastasis involved larger type A thymomas.
Purpose of the Study:
- To report an unusual case of pulmonary metastasis from a small type A thymoma.
- To emphasize the need for vigilance in diagnosing metastasis even in small thymomas.
Main Methods:
- Case report of a 62-year-old patient with a mediastinal tumor and lung nodule.
- Diagnostic workup included chest radiography, CT, and PET/CT.
- Surgical resection and pathological diagnosis of atypical type A thymoma with pulmonary metastasis.
Main Results:
- A 12 mm anterior mediastinal tumor (atypical type A thymoma) and a 13 mm left lower lobe nodule were identified.
- Pathology confirmed pulmonary metastasis from the thymoma.
- The patient was classified as stage IVb (TNM and Masaoka staging) and showed no recurrence post-surgery.
Conclusions:
- This is the smallest reported type A thymoma with pulmonary metastasis.
- Pulmonary metastasis should be considered in type A thymomas, irrespective of size (even < 20 mm).
