부산대학교 도서관

Almost all metastatic lesions from thymomas invade adjacent organs or spread along the pleura or pericardium. Intrapulmonary metastases are rare, and extensive multiple intrapulmonary metastases are extremely rare. We report the case of an invasive thymoma with multiple lung metastases in an asymptomatic 45-year-old woman. Her chest computed tomographic (CT) scan showed an irregular-shaped calcified tumor in the anterior mediastinum and multiple well-defined variable-sized tumors in both lung parenchymas. She underwent a CT-guided biopsy of the retrocardial metastatic lesion. The morphology was spindle-shaped, which was once considered to be type A thymoma according to the World Health Organization classification. The anterior mediastinal tumor was resected and proved to be type B3. Differences in the histology between the main tumor and the deep-seated metastatic lesions are possible, depending on the choice of diagnostic tools. Thymoma with extensive multiple intrapulmonary metastases is extremely rare. It should be emphasized that thymectomy is necessary to achieve a correct diagnosis in this condition. The influence of the differences on invasiveness, best treatment, and long-term outcome remains unclear.