Sara Fernandes, MD
Sara Fernandes, MD1; José Estevão-Costa, MD, PhD2; Nuno Farinha, MD3; Ana Catarina Fragoso, MD, PhD2; 1Department of Pediatric Surgery - Centro Hospitalar Universitário São João; 2Department of Pediatric Surgery - Centro Hospitalar Universitário São João. Faculty of Medicine, Porto University.; 3Pediatric Oncology Department - Centro Hospitalar Universitário São João
Thymus experiences multiple physiologic, morphologic and topographic changes with time that interfere with the interpretation of imaging findings and with the diagnosis of pathologic alterations.
An asymptomatic 6-year old girl was referred with the evidence of a paracardiac mass. Computed tomographic scanning revealed a thymic hyperplasia and an expectant attitude was initially adopted but the persistent finding of mediastinal enlargement lead to further investigation. A magnetic resonance imaging has shown a paracardiac mass, raising the possibility of a massive thymic hyperplasia, not excluding the diagnosis of a thymoma. Surgical removal was decided and performed by thoracoscopy. The patient was discharged in the second postoperative day. The histological analysis has revealed a complete exeresis of a B2a thymoma.
Although rare, thymomas may present an uncertain biological behavior and a complementary treatment may be necessary if the surgical removal is incomplete.