Giant thymoma with complete superior vena cava obstruction

Thymomas are rare epithelial tumors of the mediastinum with relatively good prognosis compared to other thoracic malignancies. Surgery is considered the best treatment and the most important determinant of long-term survival even in advanced stages. Nevertheless, complete resection may be challenging and require a multimodality approach. We present a case of a stage IVa thymoma surgically treated. The superior vena cava was completely occluded and, after resection, reconstruction was deemed unnecessary due to sufficient venous return through the azygos-inferior vena cava system. In our opinion, despite the morbidity of surgery in advanced thymomas, it should always be considered in expert hands.