Progressive Dyspnea in a 40-Year-Old Man Caused by Giant Mediastinal Thymolipoma

Abstract

Thymolipomas are rare tumors of the anterior mediastinum containing both thymic stroma and an abundance of fat. We present a 40-year-old man with no underlying disease who presented with cough and progressive dyspnea. Clinical evaluation revealed a giant mass of lipid density filling almost the entire left hemithorax with mediastinal shift. Total excision of the 40 × 33 × 8 cm mass weighing 4 kg was performed via a left thoracotomy and the histopathologic diagnosis of the mass was reported as thymolipoma. The patient remains alive and disease-free, twelve months after the intervention.

Thymoangiolipoma: A rare histologic variant of thymolipoma in a patient with myasthenia gravis

“…Computed tomography and magnetic resonance imaging are usually diagnostic. 6,7 Histopathologically, thymolipomas are composed of mature fatty tissue admixed with thymic tissue including epithelial islands and aggregates of mature lymphocytes. 1 In addition to classic morphology of thymolipoma, there are rare histologic variants in the literature.…”

“…5 Histologic differential diagnosis of thymolipoma includes mediastinal lipoma, mediastinal liposarcoma, thymic hyperplasia, teratoma, and regressed thymoma. 2,7,10 Differentiation between lipoma and thymolipoma can sometimes be difficult. Identification of epithelial thymic cells with thorough sectioning and immunohistochemical markers is helpful for differentiation.…”

Case Report of An Unusual Mediastinal Mass - Thymolipoma

“…[1] Differential diagnosis includes thymic hyperplasia, lipoma and liposarcoma of the mediastinum. [2] Lipoma will lack thymic epithelial tissue and liposarcoma will show higher degree of atypia and lipoblasts. In thymic hyperplasia, adipose tissue is usually not seen.…”

“…Thymolipomas are rare, slow-growing, benign anterior mediastinal neoplasms composed of an admixture of mature adipocytes and nonneoplastic thymic tissue. [1] Any age group can be affected [2] and accounts for 2-9% of all thymic neoplasms. [3] It is mostly an incidental finding that is diagnosed during a workup for other medical problems.…”

Atypical uniportal thoracoscopic resection of a giant thymolipoma

“…In some studies, cases of thymolipoma with progressive huge dimensions; it has been reported that there were symptoms of dyspnea, chest pain, cough and respiratory infections [4,5]. In the differential diagnosis of anterior mediastinal lesions, the most effective method in radiological evaluation is contrast-enhanced CCT [6,7].…”