YO38 - Cerebral metastases from a thymic malignancy: a case report

Case summary

Thymomas constitute 10% of mediastinal tumours and are often benign epithelial neoplasms of the thymus gland. Up to a third of cases of thymomas are malignant and causes local infiltration to surrounding structures. Rarely, they metastasize to distant organs. We report a case of slow growing thymoma which progressed into cerebral metastases. A 53 year old lady presented with 5 years history of a mediastinal tumour. She initially refused any therapy at the first presentation. She returned with an enlarging anterior mediastinal mass causing chest pain and cough. Thoracic CT revealed a 10 cm right anterior mediastinal mass abutting the pericardium. Histopathological examination of the mediastinal mass biopsy indicated thymoma. She was planned for surgical resection however developed acute neurological symptoms of headache, confusion and memory loss. Cranial MRI showed multiple lesions in the temporoparietal lobe, left frontal lobe, internal capsule and basal ganglia. Stereotactic biopsy confirmed metastases from a B1 type thymoma. She deteriorated rapidly and died without any possible intervention. Intracranial metastases from thymic tumours are rare. To date, there are 45 cases reported within the literature of cerebral metastases from thymic epithelial tumours. The median survival with multiple cerebral metastases is merely 64 days, hence high suspicion of distant spread in thymic epithelial tumours and prompt surgery may potential improve the outcome in this group of patients.

Clinical trial identification

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