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Ectopic thymoma presenting as a giant intrathoracic tumor A case report.doc

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Ectopic thymoma presenting as a giant intrathoracic tumor A case report

Kitadaetal.WorldJournalofSurgicalOncology2011,9:66 /content/9/1/66 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT OpenAccess Ectopicthymomapresentingasagiant intrathoracictumor:Acasereport MasahiroKitada ,KazuhiroSato ,YoshinariMatsuda ,SatoshiHayashi ,YoshihikoTokusashi ,NaoyukiMiyokawa2 1* 1 1 1 2 andTadahiroSasajima1 Abstract Ectopicthymomararelypresentsasanintrathoracictumor.Wereportacaseofectopicthymomapresentingasa giantrightintrathoracictumorthatwastreatedwithresection.Thepatientwasa50-year-oldJapanesewoman whopresentedwiththechiefcomplaintofchestpain.Detailedexaminationrevealedasolidtumormeasuring15 ×10×8cmindiameter,withaclearborder.TheImagingfindingssuggestedasolitaryfibroustumor,andsurgery wasperformed.Atsurgery,thetumorwasfoundtobeadherenttothediaphragm,mediastinalpleura,andlower lobeofthelung,althoughitcouldbedissectedwithrelativeeaseandwasremoved.Pathologicaldiagnosis indicatedatypeB1tumorwithnocapsularinvasionaccordingtotheWorldHealthOrganizationclassification,and adiagnosisofMasaokastageIthymomawasmade.Nocontinuitywiththenormalthymustissuewasseen,and thethymomawasconsideredtobederivedfromectopicthymictissueinthepleura. Background identified onblood biochemistry. Aplaine chest x-ray Thymomas usually manifest in the anterior-superior (Figure1)showedagianttumorshadowmeasuring15× mediastinum,andectopicthymomasaccountforonly4% 13cmintherightlowerlungfield,andchestcomputed ofallthymomas.Amongectopicthymoma,intrathoracic tomography(Figure2)showedasolidtumormeasuring tumors of pleural origin are rather rare. We report, 15×10×8cmintheright thoracic cavity. Thetumor herein, apatient with agiant intrathoracic tumor that showedaclearbordersandinternalcalcification,andwas wasdiscoveredduringaclinicalworkuptodeterminethe foundtodisplacethediaphragmdownwardandtheheart causeofchestpaininthepatient. Thetumorwasdiag- totheleft.Inaddition,onchestmagneticresonanceima- nosed asathymoma that was difficult todifferentiate ging(MRI)(Figure3