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Huge thymoma: role of preoperative WHO histological classification

^a Department of General Thoracic Surgery, Osaka General Medical Center, 3-1-56 Bandaihigashi, Sumiyoshi-Ku, Osaka, 558-8558, Japan
^b Department of General Thoracic Surgery, Toneyama National Hospital, Toneyama 5-1-1 Toyonaka City, Osaka, 560-8552, Japan

Corresponding author. Tel.: +81-6-6692-1201; fax: +81-6-6606-7032.

E-mail address: stakeda{at}gh.pref.osaka.jp (S.-i. Takeda).

A 57-year-old woman was admitted to our hospital with complaints of recent onset of dyspnea on exertion. A chest computed tomography revealed a large mediastinal mass which extrinsically compressed the heart and mediastinal structures, occupying one half of the hemithorax. A needle biopsy was performed to find a thymoma with type AB according to the WHO classification. Based on the radiological and histological finding a surgery for the tumor was achieved by exploratory VATS thoracotomy followed by thymectomy through a median sternotomy with tumor extirpation of 910 g in weight. A definite diagnosis of thymoma (Masaoka I) without capsular invasion was obtained from the pathologic findings, including positive immunohistochemical staining for CD1a and cytokeratin.

Key Words: Huge thymoma; WHO classification; Masaoka stage