Ectopic thymoma presenting as a giant intrathoracic tumor: A case report
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Ectopic thymoma presenting as a giant intrathoracic tumor: A case report Masahiro Kitada1*, Kazuhiro Sato1, Yoshinari Matsuda1, Satoshi Hayashi1, Yoshihiko Tokusashi2, Naoyuki Miyokawa2 and Tadahiro Sasajima1
Abstract Ectopic thymoma rarely presents as an intrathoracic tumor. We report a case of ectopic thymoma presenting as a giant right intrathoracic tumor that was treated with resection. The patient was a 50-year-old Japanese woman who presented with the chief complaint of chest pain. Detailed examination revealed a solid tumor measuring 15 × 10 × 8 cm in diameter, with a clear border. The Imaging findings suggested a solitary fibrous tumor, and surgery was performed. At surgery, the tumor was found to beadherent to the diaphragm, mediastinal pleura, and lower lobe of the lung, although it could be dissected with relative ease and was removed. Pathological diagnosis indicated a type B1 tumor with no capsular invasion according to the World Health Organization classification, and a diagnosis of Masaoka stage I thymoma was made. No continuity with the normal thymus tissue was seen, and the thymoma was considered to be derived from ectopic thymic tissue in the pleura. Background Thymomas usually manifest in the anterior-superior mediastinum, and ectopic thymomas account for only 4% of all thymomas. Among ectopic thymoma, intrathoracic tumors of pleural origin are rather rare. We report, herein, a patient with a giant intrathoracic tumor that was discovered during a clinical workup to determine the cause of chest pain in the patient. The tumor was diagnosed as a thymoma that was difficult to differentiate from solitary fibrous tumor (SFT) by diagnostic imaging. Case A 50-year-old Japanese woman with the chief complaint of chest pain was examined at a local hospital. A chest radiograph revealed a giant tumor in the right lower lung field, and the patient was referred to our department. The patient had no pertinent personal or family history, and had never smoked. Respiratory sounds in the right lower lung field were diminished, but no other abnormalities were detected on physical examination. Respiratory function tests revealed a vital capacity (VC) of 1,470 mL and a percent predicted VC of 46.7%, indicative of restrictive pulmonary disease. No abnormalities were * Correspondence: [email protected] 1 Department of Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan Full list of author information is available at the end of the article
identified on blood biochemistry. A plaine chest x-ray (Figure 1) showed a giant tumor shadow measuring 15 × 13 cm in the right lower lung field, and chest computed tomography (Figure 2) showed a solid tumor measuring 15 × 10 × 8 cm in the right thoracic cavity. The tumor showed a clear borders and internal calcification, and was found todisplace the diaphragm downward and the heart to the left. In addition, on chest magnetic resonance imaging (MRI) (Figure 3), the
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