Thoracoscopic resection for mediastinal thymolipoma in a child

Furukawa, Taiji; Sakai, Kohei; Higashi, Michiyo; Fumino, Shigehisa; Aoi, Shigeyoshi; Tajiri, Tatsuro

doi:10.1111/ases.12627

“…This theory is based by the identification of enhanced carbohydrate antigen (CA) 19-9 serum levels in some cases of thymolipoma [ 25 , 26 ]. CA 19-9, normally produced in small quantities by thymus, shows an increased serum level due to the development of the neoplastic thymic component of the thymolipoma [ 17 , 26 ].…”

Section: ⧉ Thymolipoma Incidence and Pathogenymentioning

confidence: 99%

Thymolipoma – the frontier between hamartoma and neoplasia?

Amălinei

¹

,

Grigoraș²,

Bălan³

et al. 2021

Rom J Morphol Embryol

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Thymolipoma is an uncommon benign thymus lesion, with a partially deciphered etiopathogeny, being most frequently diagnosed in young patients, regardless of gender. Incidentally diagnosed in asymptomatic patients, larger thymolipomas lead to symptoms related to neighboring mediastinal structures compression, with an intensity which is correlated with the mass size. Our review presents the main epidemiological, pathogenic, clinicopathological and morphological characteristics of this rare pathology. Sometimes, thymolipomas may be associated with paraneoplastic syndromes, which are alleviated by the mass complete surgical resection. Imagistics may orientate the diagnosis, which is certified by the microscopic examination of the resection specimens. Extensive thymectomy remains the current therapeutic option and new tools have been developed to increase the accuracy of the surgical procedure to avoid incidental lesions of the important elements of the anterior mediastinum. Although rare, thymolipomas should be considered in the differential diagnosis of mediastinal masses and of paraneoplastic syndromes.

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“…This theory is based by the identification of enhanced carbohydrate antigen (CA) serum levels in some cases of thymolipoma [25,26]. CA 19-9, normally produced in small quantities by thymus, shows an increased serum level due to the development of the neoplastic thymic component of the thymolipoma [17,26]. The second theory is suggesting that thymolipomas are thymic hamartomas, formed by an admixture of white adipose tissue (30% to 80%) associated with thymus epithelium [20,27].…”

Section:  Thymolipoma Incidence and Pathogenymentioning

confidence: 99%

“…Another theory is proposing that thymolipomas are the result of involution of thymic hyperplasia or of a regressed thymoma [8,17]. In thymic hyperplasia involution, an increased thymic volume beyond the normal level for the patient's age is noticed, because of an expansion of white adipose tissue, which progressively replaces thymus parenchyma [8,20,34].…”

Section:  Thymolipoma Incidence and Pathogenymentioning

confidence: 99%

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2021

Rom J Morphol Embryol

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Thymolipoma is an uncommon benign thymus lesion, with a partially deciphered etiopathogeny, being most frequently diagnosed in young patients, regardless of gender. Incidentally diagnosed in asymptomatic patients, larger thymolipomas lead to symptoms related to neighboring mediastinal structures compression, with an intensity which is correlated with the mass size. Our review presents the main epidemiological, pathogenic, clinicopathological and morphological characteristics of this rare pathology. Sometimes, thymolipomas may be associated with paraneoplastic syndromes, which are alleviated by the mass complete surgical resection. Imagistics may orientate the diagnosis, which is certified by the microscopic examination of the resection specimens. Extensive thymectomy remains the current therapeutic option and new tools have been developed to increase the accuracy of the surgical procedure to avoid incidental lesions of the important elements of the anterior mediastinum. Although rare, thymolipomas should be considered in the differential diagnosis of mediastinal masses and of paraneoplastic syndromes.

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Robotic resection of a giant thymolipoma in a pediatric patient

Hanke,

Emr,

Taylor

et al. 2024

Journal of Surgical Case Reports

0

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Thymolipomas are benign lesions in the anterior mediastinum that most commonly present in the first three decades of life. They often are asymptomatic and can be very large at time of diagnosis. After incidental detection of a thoracic mass on an abdominal ultrasound, an otherwise well 10 years old male was evaluated with further imaging, including a cardiac-gated magnetic resonance imaging (MRI) study. This demonstrated that the mass was intimate with but did not appear to invade the pericardium, likely originating from the thymus. Despite the large size, the patient underwent robotic resection of the mass and we include photographs illustrating the minimally invasive approach and highlighting critical structures. The patient tolerated the procedure well and recovered quickly. Final pathology was consistent with a giant thymolipoma. In summary, workup of giant thymolipomas is optimized with cardiac gated imaging. Despite their large size, these can be safely managed in a minimally invasive fashion in pediatric patients.

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Thoracoscopic resection for mediastinal thymolipoma in a child

Cited by 4 publications

References 7 publications

Thymolipoma – the frontier between hamartoma and neoplasia?

Thymolipoma – the frontier between hamartoma and neoplasia?

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Robotic resection of a giant thymolipoma in a pediatric patient

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