Spleen metastasis as rare systemic manifestation of thymoma: a case report

Thymomas are thymic epithelial tumors (TETs) and the most common tumors of the anterior mediastinum. In the natural course of this malignancy, there is no tendency towards extrathoracic metastasis. This report describes an extremely rare case of splenic metastatic disease from a thymoma. Additionally, the patient developed Good's syndrome, a thymoma-associated immunological disorder which makes the patient vulnerable for opportunistic infections. This syndrome is generally treated with intravenous immunoglobulins.

The patient is an asymptomatic 73-year-old man of Caucasian origin without significant past medical history. He was diagnosed with an anterior mediastinal mass on computed tomography (CT) of the chest in the work-up of his newly diagnosed prostate carcinoma, which turned out to be a thymoma after surgical resection. During follow-up the patient developed a splenic lesion which was difficult to characterize. After laparoscopic splenectomy the diagnosis of metastatic thymoma was confirmed. Additionally, the patient developed Good's syndrome. Unfortunately, the patient died of associated infectious complications after thorough intensive care treatment.

Metastatic splenic disease from a thymoma, further complicated by development of Good's syndrome is extremely rare and hitherto never described before. To anticipate possible infectious complications in patients with newly diagnosed thymoma, we advise to routinely check immunoglobulin levels in these patients.