Abstract
BackgroundAn atypical type A thymoma variant was newly added to the WHO classification of type A thymoma family in 2015.Case presentationA 72-year-old female was present a large round mass in the anterior mediastinum. The radiological examination led to a preoperative diagnosis of non-invasive thymoma. Tumor resection was undertaken via median sternotomy. Complete removal of the mediastinal tumor was achieved. Pathological examination revealed that the tumor cells were spindle- and oval-shaped with atypia. Immunohistochemical work-up revealed that the tumor was type A thymoma. On the basis of these findings, the tumor was finally diagnosed to be an atypical type A thymoma variant.ConclusionsPreoperative diagnosis as atypical type A thymoma variant based on radiological examination is difficult. In case of atypical type A thymoma variant, a careful postoperative systemic follow-up should be done.
Highlights
An atypical type A thymoma variant was newly added to the WHO classification of type A thymoma family in 2015.Case presentation: A 72-year-old female was present a large round mass in the anterior mediastinum
Preoperative diagnosis as atypical type A thymoma variant based on radiological examination is difficult
On the basis of these reports, atypical type A thymoma variant was added to the type A thymoma family as a small subset of aggressive tumors [5, 6]
Summary
Type A thymoma is recognized as a benign tumor with excellent prognosis [1]. Several authors have reported type A thymoma showing atypical features with postoperative tumor relapse [2,3,4]. We present the case of an atypical type A thymoma variant. Contrast-enhanced CT (CE-CT) revealed that the mediastinal mass was not invading the surrounding organs (Fig. 1b). Pathological findings showed that the tumor was surrounded by a fibrous capsule (Fig. 2a), and its cells were spindle- and oval-shaped (Fig. 2b). On the basis of these findings, the tumor was diagnosed to be an atypical type A thymoma variant. Her postoperative course was uneventful, and she was discharged on foot 12 days after surgery. She is doing well without recurrence until last follow-up at 15 months
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