Two Thymomas of Different Histological Subtypes Arising in a Giant Thymolipoma: Case Report and Review of the Literature

Int J Surg Pathol. 2023 Aug;31(5):813-818. doi: 10.1177/10668969221137523. Epub 2022 Nov 27.

Abstract

Thymolipoma is a rare benign tumor of the anterior mediastinum. Only a few reports describing thymoma arising within a thymolipoma have been documented in the literature. We report herein a detailed description of thymolipoma giving rise to 2 thymomas of different histological subtypes. A 74-year-old male with history of metastatic papillary thyroid carcinoma gradually developed 2 soft tissue nodules within a large right hemithorax fatty mass that was present for the past 20 years. Computed tomography (CT)-guided needle biopsy revealed one of the soft tissue nodules to be a thymoma, and the entire mass was surgically resected. Final pathological examination demonstrated the mass to be a thymolipoma containing a micronodular thymoma with lymphoid stroma as well as a WHO type B1 thymoma. No evidence of disease recurrence was seen at the time of his 7-year follow-up. This case documents a rare presentation of thymolipoma harboring 2 thymomas of different histological subtypes and highlights the need for early surgical resection of thymolipomas, as they may harbor malignant nodules.

Keywords: mediastinum; micronodular thymoma with lymphoid stroma; thorax; thymolipoma; thymoma.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Aged
  • Humans
  • Lipoma* / diagnosis
  • Lipoma* / pathology
  • Lipoma* / surgery
  • Male
  • Neoplasm Recurrence, Local
  • Thymoma* / diagnosis
  • Thymoma* / pathology
  • Thymoma* / surgery
  • Thymus Gland / pathology
  • Thymus Neoplasms* / diagnosis
  • Thymus Neoplasms* / pathology
  • Thymus Neoplasms* / surgery
  • Tomography, X-Ray Computed / methods