Thymoma complicated by deep vein thrombosis of the arm

Description

Our patient was referred urgently with an anterior neck lump. The patient was otherwise well with no history of smoking or radiation exposure. Initial investigation with ultrasound-guided aspiration cytology was suspicious and atypical for thyroid carcinoma. A CT scan demonstrated the neck lump was part of a 64x56x54 mm retrosternal mass infiltrating the superior vena cava and atrium (figure 1).

Figure 1

CT scan demonstrating deep extension of retrosternal lesion into the anterior mediastinum, where a more focal 64x56x54 mm mass is seen. The mass is partly cystic, centred towards the left of the anterior mediastinum, and directly infiltrates the superior vena cava and atrium.

Surgical biopsy and histological analysis demonstrated a mixed widely invasive thymoma P1 prominent with some P2 elements, Masaoka stage 3. A positron emission tomography-CT scan was arranged to identify any signs of metastasis (figure 2)....

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