Ectopic thymoma in the paratracheal region of the middle mediastinum: a rare case report and literature review

Yajima, Toshiki; Mogi, Akira; Shimizu, Kimihiro; Kosaka, Takayuki; Nagashima, Toshiteru; Ohtaki, Yoichi; Obayashi, Kai; Nakazawa, Shozo; Iijima, Misaki; Yoshida, Yuka; Hirato, Junko; Kuwano, Hiroyuki

doi:10.1186/s13104-018-3359-9

Cited by 9 publications

(11 citation statements)

References 16 publications

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“…Only 2 patients were symptomatic, and the histologic type B3 was seen only in 1 patient. 1 The maximum size reported thus far is 7.5 cm, while our patient’s tumor was about 13 cm in size. Its histologic type was similarly a rare form of the ectopic thymoma B3.…”

Section: Discussionmentioning

confidence: 54%

“…With regard to their unusual site, the most important point is to differentiate them from other mediastinal tumors. 1 - 3 Different diagnostic imaging modalities such as chest X-ray, echocardiography, computed tomography (CT), and magnetic resonance imaging can be helpful in differential diagnostic and prognostic purposes. 4 We herein present a very rare case of a giant ectopic thymoma, as an unusual intrapericardial tumor, in an old man with a complaint of dyspnea and cardiomegaly in his chest X-ray.…”

Section: Introductionmentioning

confidence: 99%

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Bloody Pericardial Effusion with a Huge Pericardial Mass: A Case Report

Zoroufian

Shirzad

Shahbazi

et al. 2020

JTHC

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Nowadays, the early diagnosis of tumoral diseases is more possible and accurate with multiple diagnostic imaging modalities such as chest X-ray, echocardiography, computed tomography, and magnetic resonance imaging, especially for cardiac tumors which are usually asymptomatic, even in large sizes. In cardiac masses, the patients’ presentations are nonspecific and dependent on the tumor size and site as well as its compressive effect on the adjacent structures. On the other hand, the first and last signs could be sudden cardiac death. However, cardiac masses are either benign or malignant and metastatic in their malignant type, and their definite diagnosis is only possible by surgical tumor resection and tissue biopsy. In this paper, we describe an old patient with severe pericardial effusion and an unusual intrapericardial tumor in transthoracic echocardiography, representing a rare case of a giant ectopic thymoma after surgical resection and pathologic assessment.

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Bloody Pericardial Effusion with a Huge Pericardial Mass: A Case Report

Zoroufian

Shirzad

Shahbazi

et al. 2020

JTHC

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“…Thymomas often occur in the anterosuperior mediastinum [6]. On the other hand, ectopic thymomas are considered to arise from thymic tissue that has failed to migrate into the anterosuperior mediastinum [7], accounting for only 4% of all thymomas [7], 8]. Weissferdt et al [6] reported that the incidence of ectopic thymomas was highest in the cervical region (45%), followed by the lungs (20%) and pleura (13%); other reported sites include the thyroid gland (6%), pericardium (7%), and middle/posterior mediastinum (4%).…”

Section: Discussionmentioning

confidence: 99%

An ectopic thymoma arising in the middle mediastinum that was difficult to distinguish from a lymph node metastasis

et al. 2021

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Background Ectopic thymomas often occur in the upper mediastinum; however, they rarely arise in the middle mediastinum, especially on the dorsal side of the innominate vein and superior vena cava in the peribronchial region. Case presentation Six years prior, a 27-year-old female presented to our department and was diagnosed with locally advanced left breast cancer. First, we administered chemotherapy including an anti-human epidermal growth factor receptor 2 antibody. The size of the tumor was markedly reduced, and a radical operation involving mastectomy and axillary lymph node dissection was then performed. The patient underwent radiotherapy after the mastectomy, followed by trastuzumab therapy; she continued to receive endocrine therapy thereafter. She underwent computed tomography once a year after the surgery, and a nodule in the middle mediastinum on the dorsal side of the innominate vein and superior vena cava in the parabronchial region was detected at 4 years. We speculated that the nodule was a solitary mediastinal lymph node metastasis from her breast cancer; therefore, we performed thoracoscopic resection of the tumor. We diagnosed the tumor as a thymoma. Currently, the patient visits our hospital to receive continuous hormone therapy for her breast cancer, and the latest computed tomography scan demonstrated no metastases from or recurrence of her breast cancer or thymoma. Conclusions We report a case of ectopic thymoma in the middle mediastinum. The tumor, which was detected during systemic therapy for locally advanced breast cancer, was located on the dorsal side of the innominate vein and superior vena cava in the parabronchial region and was indistinguishable from a lymph node metastasis from breast cancer.

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“…EBUS-TBNA provides minimally invasive approach for diagnosing mediastinal tumors including thymomas and other thymic tumors (36,(42)(43)(44)(45)(46). The diagnostic yield of this technique in mediastinal masses has been shown to be up to 93% (87% in malignant and 96% in benign masses) (42).…”

Section: Endobronchial Ultrasound-guided Transbronchial Needle Aspirationmentioning

confidence: 99%

“…The diagnostic yield of this technique in mediastinal masses has been shown to be up to 93% (87% in malignant and 96% in benign masses) (42). Most of the articles on EBUS-TBNA in thymic tumors are case reports (44)(45)(46). There are only few studies (6,36) owing to the rarity and anterior mediastinal location of thymic tumors not usually accessible by this procedure.…”

Section: Endobronchial Ultrasound-guided Transbronchial Needle Aspirationmentioning

confidence: 99%

How to obtain adequate biopsy specımen in suspected thymic tumors

Bilaçeroğlu¹

2020

J Thorac Dis

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Pathologic diagnosis of thymic tumors (TTs) can be made by surgical or nonsurgical procedures. About 20% of TTs had been diagnosed by pretreatment biopsy methods while the rest had gone to surgery for diagnosis and treatment. However, in the last two decades there was an increase in pretreatment procedures for optimal management of locally advanced or metastatic TTs. Pretreatment tissue diagnosis of a noninvasive TT is not a standard option but is required if there is suspect or atypical clinical presentation and imaging, an invasive tumor requiring a nonsurgical approach or preoperative chemotherapy or chemoradiotherapy, strong possibility of lymphoma or unclear differential diagnosis between lymphoma or other solid tumor by imaging studies, or suspicion of a metastatic lesion. In surgical diagnosis anterior mediastinotomy, video-assisted thoracic surgery or mediastinoscopy can be chosen for invasive TTs whereas total resection is performed for small, noninvasive tumors. Nonsurgical diagnosis can be made by transthoracic fine or core needle biopsies (TTFNA, TTCNB), conventional bronchoscopy, endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA), endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) or medical thoracoscopy depending on procedural amenability according to tumor extension. TTFNA and TTCNB have been the most frequently used nonsurgical methods. However, there is an upward trend in using conventional bronchoscopy, EBUS-TBNA, EUS-FNA and medical thoracoscopy recently. To increase the diagnostic performance of these procedures in TTs, recommendations are (I) obtaining histologic specimens, (II) combining smears or liquid based cytology preparations and cell blocks, (III) obtaining multiple sufficient samples, (IV) combining histologic and cytologic specimens, (V) performing morphologic, immunohistochemical and molecular analyses on all specimens, (VI) using rapid onsite evaluation for cytologic specimens, (VII) correlating pathologic, clinical and radiologic findings, (VIII) consulting experienced pathologists.

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Ectopic thymoma in the paratracheal region of the middle mediastinum: a rare case report and literature review

Cited by 9 publications

References 16 publications

Bloody Pericardial Effusion with a Huge Pericardial Mass: A Case Report

Bloody Pericardial Effusion with a Huge Pericardial Mass: A Case Report

An ectopic thymoma arising in the middle mediastinum that was difficult to distinguish from a lymph node metastasis

How to obtain adequate biopsy specımen in suspected thymic tumors

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