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A case of malignant thymoma with extrathoracic metastases is described and discussed. A review of the literature revealed only 11 such cases previously reported. Pertinent clinical and pathologic data are reviewed and discussed. The age range was 32 to 74 years, with a mean of 49.5 years. The duration of life from onset of symptoms to time of death ranged from 2 1/2 months to 14 years, with a mean of 3.9 years. The relatively rapid evolution from onset of symptoms to time of death was probably related to late diagnosis rather than to aggressiveness of the neoplasm, since this type of tumor is usually slow growing. At postmortem examination, all cases showed a large mediastinal tumor in addition to extrathoracic metastases. Microscopic examination of the tumors found 8 to be predominently epithelial, one made up of spindle cells, 2 of a combination of epithelial and spindle cells, and one of lymphocytic type. The rare occurrence of extrathoracic spread of thymoma is attributed to relative lack of host defenses, though in our reported case a strong desmoplastic reaction is held accountable for the longest reported survival (14 years).

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