A rare appearance in type 2 thymoma: Ossification

Yener Aydın¹, Hayri Oğul², Ebru Şener³, Ali Bilal Ulaş¹, Atilla Eroğlu¹

¹Department of Thoracic Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
²Department of Radiology, Atatürk University Faculty of Medicine, Erzurum, Turkey
³Department of Pathology, Atatürk University Faculty of Medicine, Erzurum, Turkey

DOI : 10.5606/tgkdc.dergisi.2019.17981

A 40-year-old man presented with a complaint of chest pain. The patient underwent percutaneous treatment for a hydatid cyst of the liver three months ago. Sagittal (Figure 1a) and coronal (Figure 1b) contrast-enhanced thoracic computed tomography revealed a retrosternal calcified mass. The patient underwent thoracoscopic resection with preliminary diagnoses of a complicated hydatid cyst, cystic teratoma, or malignant mediastinal tumor. Following resection, the lesion was unable to be removed from the thoracoscopic port hole due to ossification (Figure 2). It was removed with a utility thoracotomy. Histopathological examination result was reported as type 2 thymoma according to the Masaoka system.

Figure 1: Retrosternal calcified mass is seen in the sagittal (a) and coronal (b) contrast-enhanced thoracic computed tomography images.

Figure 2: Ossification is seen in the resected material as macroscopic.

Masses containing mediastinal ossification are rarely seen.[1] Thymoma is one of the most common mediastinal tumors. However, ossification is very rare and reported in the literature only as case reports.[2-4] As in the presented case, type 2 thymoma may exhibit extensive ossification.

Declaration of conflicting interests
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Funding
The authors received no financial support for the research and/or authorship of this article.

References

1) Aydin Y, Gürsan N, Türkyılmaz A, Eroğlu A. Mediastinal calcified hydatid cyst. Ann Thorac Surg 2011;92:e85.

2) Chaturvedi M, Kalgutkar AD, Khandekar JV. Extensive ossification of thymoma in a child. Ann Thorac Surg 2013;95:e139-41.

3) Jung JJ, Kim SH, Kang DH, Kim KN, Moon SH, Yang JH, et al. Invasive thymoma with multiple ring calcifications and osseous metaplasia: A case report. Thorac Cancer 2018;9:1509-12.

4) Nakada T, Akiba T, Yabe M, Tanaka K, Nakano M, Suzuki M, et al. Clinicopathological Features of Thymoma with Ring Calcification: Case Reports. Ann Thorac Cardiovasc Surg 2017;23:256-61.

References

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