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The authors present the case of a 31-year-old woman with a massive anterior mediastinal tumor who presented with respiratory failure. A thoracic computed tomographic scan suggested a mediastinal lipomatous mass, and an operation was performed. Resection of the tumor resulted in immediate improvement in the patient's pulmonary status, and the histopathologic examination revealed thymolipoma. Because thymolipoma can attain enormous dimensions and compress adjacent structures, it should be immediately resected.

A 45-year-old woman was seen at the hospital because of an antetior neck nodule pointed out at a recent medical checkup. The nodule was diagnosed as intrathoracic goiter by neck CT and MRI. She was also pointed out an abnormal shadow on a chest X-ray film. Chest CT demonstrated a huge lipodensity mass pressing the right middle lobe of the lung in the anterioinferior mediastinum. The clinical diagnosis was lipoma or thymolipoma arising from the mediastinum. Right lobectomy including intrathoracic part of the thyroid and an extirpation of the huge mediastinal tumor were performed. Histologically, the specimen of anterior neck tumor (256g) was adenomatous goiter and the specimen of the huge tumor (2000g) of the mediastinum was thymolipoma. Thymolipoma associated with intrathoracic goiter is very rare and this is the first case report as far as we could review.

Thymolipoma, a rare benign neoplasm of the anterior mediastinum, is often asymptomatic and as a result it can become quite large before it is diagnosed. CT is the most accurate diagnostic technique to identify the adipose tissue, but it often cannot make a differential diagnosis differentiating it from other anterior mediastinal masses; transthoracic biopsy also reveals the presence of fatty tissue, but a definitive diagnosis can only be achieved by means of surgical excision, which is also curative. We describe the case of a young woman who presented with a fatty neoplasm of the anterior mediastinum. The mass was removed using single-stage bilateral sequential videothoracoscopy. The histopathological diagnosis was thymolipoma.

甲状腺機能亢進症を伴った胸腺脂肪腫の症例を経験した.症例は47歳の女性, 3年前よりGraves病を指摘されていた.肺炎治療時の胸部CT検査で前縦隔の異常影を発見された.胸骨正中切開アプローチで摘出したところ, 胸腺脂肪腫と診断された.成書には胸腺脂肪腫と甲状腺機能亢進症が合併する可能性が記載されているが, 実際の報告例は極めて少数であり, 我々が調べえた限りでは, 国外ではBentonの報告以後3例であり, 本邦では自験例が最初の報告である.また, この計4例のうちBentonの報告と自験例以外の2例は重症筋無力症を合併していたものであり, 甲状腺機能亢進症と胸腺脂肪腫のみの組み合わせでは自験例は2例目といえる.合併の理由について現時点で断言するのは困難であるが, 自験例では, 甲状腺機能亢進症と胸腺脂肪腫中の胸腺成分の関与が示唆され, また, 過形成性胸腺の退縮と脂肪成分の増殖が胸腺脂肪腫の成因として推測された.

We report three recently resected cases of thymolipoma. Two cases (case 2 and 3) were female and the other (case 1) was male. The age of these three were 41 years, 63 years, and 29 years, respectively. While two cases (case 1 and 2) were asymptomatic, the other (case 3) had associated myasthenia gravis. Preoperative examination in each case was performed using chest CT scan or chest MRI, or both. Only one case (case 1) was diagnosed as thymolipoma preoperatively, and this was by a chest MRI showing the mass in continuity with the thymus. The diagnosis of each lesion was confirmed histologically by their composition of lobules of mature adipose tissue with minute islands of thymic tissue consisting of epithelial cells, lymphocytes, and Hassall's bodies.

Thymolipoma is a very rare anterior mediastinal mass of thymic origin, accounting for only 2% to 10% of all thymic neoplasm. Histologically, the tumor is usually composed of adipose tissue interspersed with thymic tissues. We report a case of a 58-year-old man who presented with a few weeks history of shortness of breath, cough, and chest pain, found to have a retrocardiac infiltrate on chest X-ray. Computed tomography scan of the chest showed a large anterior mediastinal mass. Surgical excision revealed an ovoid fatty mass, which on histological examination displayed thymic tissue intermixed with lipomatous tissue consistent with a thymolipoma. Of note was the presence of a microscopic nodule of thymic epithelial proliferation with sebaceous differentiation and focal cylindroma-like architecture. Although sebaceous tissue has been rarely reported in thymic tissue, to the best of our knowledge, this is the first case report of sebaceous differentiation in a thymolipoma.

Thymolipoma is a rare anterior mediastinal tumor composed of mature adipose tissue and benign thymic tissue, and is a benign neoplasm for which complete surgical excision is curative.1 Literature has reported that the thymic parenchyma of thymolipoma exceptionally contain myoid cells that are immunoreactive for desmin, muscle-specific actin and myoglobin.2,3 Herein, we describe a very rare case of thymolipoma with myoid cells. To the best of our knowledge, this is the sixth case of thymolipoma containing striated myoid cells in the English literature since 1972.

金沢大学医薬保健研究域医学系, 最近われわれは, 稀な胸腺腫瘍の2例を経験した.症例1は72歳, 女性の胸腺に発生した悪性黒色腫であった.悪性黒色腫の胸腺発生例は本邦報告史上2例を認めるのみであり, 本例は第3例目に相当した.腫瘍は6.5×5.5×3.5cm大の被包化された充実性腫瘍であった.周囲組織への浸潤はなく, 周囲のリンパ節に転移はなかった.原発巣不明黒色腫の転移の可能性は否定しきれないが, 胸腺原発を最も疑った.正常胸腺を含めて腫瘍を摘出した。術後5ヵ月を経て再発なく生存中である.症例2は21歳男性に発生した胸腺脂肪腫であり, 周囲の脂肪組織を含めて腫瘍を摘出した.摘出腫瘍の重量は390gであり, 重症筋無力症の合併はなかった.

1. Oppenheimer BS, Oppenheimer ET, Stout AP, et al. The latent period in carcinogenesis by plastics in rats and its relation to the presarcomatous stage. Cancer. 1958;11:204. 2. Jennings TA, Peterson L, Axiotis CA. Angiosarcoma associated with foreign body material. Cancer. 1988;62:2436-44. 3. Ben-Izhak O, Vlodavsky E, Ofer A. Epithelioid angiosarcoma associated with a Dacron vascular graft. Am J Surg Pathol. 1999;23(11):1418-22. 4. Fyfe BS, Quintana CS, Kaneko M. Aortic sarcoma four years after Dacron graft insertion. Ann Thorac Surg. 1994;58:1752-4. 5. Weiss WM, Riles TS, Gouge TH, et al. Angiosarcoma at the site of a

On physical examination, the patient was hydrated, acyanotic,anicteric, eupneic, afebrile, with healthy coloring, in regular gene-ral condition, and had neither jugular venous distension nor peri-pheral edema. His blood pressure was 140/100 mmHg and hisheart rate was 120 bpm. His pulses were palpable, symmetric,rhythmic, with no changes in peripheral perfusion. The ictus cordiswas located on the fifth left intercostal space, at the level of theleft midclavicular line, and had approximately 2 digital pulps. Thecardiac sounds had normal intensity and no cardiac murmur washeard. On pulmonary auscultation, the respiratory sounds werepresent bilaterally, and no rales were heard. The abdomen wasflat, flaccid with hydro-aerial noises, not tender on palpation, andno visceromegaly was observed.The biochemical tests and electrocardiogram showed nochanges. On chest radiography, a mild enlargement of the cardiacarea was observed with an expanding lesion in the anteroinferiormediastinum, in continuity with the cardiac image (fig.1). Theesophagogram showed no signs of extrinsic compression of theesophagus. Upper digestive endoscopy showed only a mild enan-thematous antral gastritis.Transthoracic echodopplercardiography showed a mild extrinsiccompression of the anterolateral region of the right atrium. Thetransesophageal echocardiogram confirmed this compression withno significant hemodynamic repercussions, and the presence of amild systolic reflux (escape) in the tricuspid valve (fig. 2).To complement the investigation, the patient underwent chestcomputed tomography performed with 5- and 10-mm-thick axialsections after intravenous infusion of contrast medium. The tomo-graphy revealed the presence of an expanding lesion with a fatattenuation coefficient, regular and precise contours, located in theanterior mediastinum to the right, slightly deviating from the rightatrium posteriorly. The lesion measured 12.0 x 7.4 x 9.6 cm andwas suggestive of thymolipoma or pericardial lipoma (fig. 3).With these hypotheses, the patient was referred for surgicaltreatment. Thoracotomy provided complete excision of the tumoralmass, which weighed approximately 580 g. No regional macros-copic metastases were evident, and later anatomicopathologicalexamination confirmed the diagnosis of thymolipoma (fig. 4).

Thymolipoma is a rare, slow-growing, benign tumor that arises from the anterior mediastinum and corresponds to 2% to 9% of all thymic neoplasms. We present the case of a 49-year-old man who had a large heterogeneous mass with areas of soft tissue and fat tissue located on the anterior mediastinum and right hemithorax. After resection, histologic analysis confirmed the diagnosis of a giant thymolipoma containing solid components that corresponded to thymomas B1, B2, and B3. We discuss the occurrence of an atypical variant of thymolipoma containing three types of thymomas inside.

A superior-anterior mediastinal tumor was excised from a 50-year-old man. The 207-g mass was encapsulated and multilobulated. It contained adipose tissue and abnormal thymic tissue. In some areas the thymic tissue was characterized by cords and nests of epithelial cells lying within either the adipose tissue or a myxoid matrix. Other areas were characterized by cortical thymic tissue with increased numbers of epithelial cells. Foci of normal medullary tissue were present. The prominent epithelial cells were immunoreactive for cytokeratin and nonimmunoreactive for vimentin, S-100, chromogranin, and parathyroid hormone. Flow cytometry showed that the lymphocyte populations were consistent with a late cortical thymic phenotype. The tumor was diploid. By electron microscopy, the prominent epithelial cells had desmosomes and a few tonofilaments. The cytoplasm contained additional organelles including mitochondria, polyribosomes, and occasional lysosomes. Nuclei were oval and had relatively smooth contours, prominent nucleoli, and moderate quantities of heterochromatin. Basal lamina was present around many nests and cords of cells. This is the first such study of a tumor with this histology.

A 35-year-old Indian working in Dubai had come to India for his annual vacation. He presented with a shortness of breath and mild chest discomfort of 3 months duration. Routine investigations gave normal results, except for his chest x-ray that showed homogenous opacity in the right mid and lower zones. Chest CT scan revealed a huge mass with fat and soft tissue involving the anterior mediastinum predominantly on the right side extending into the pericardiac region. The mass was pushing the right hemidiaphragm inferiorly and was compressing the right lung superiorly with atelectasis. The patient underwent surgical excision of the mass and recovered uneventfully. Gross specimen showed an encapsulated mass weighing 2.585 kg. Histopathological examination revealed lobules of mature adipose tissue interspersed with islands of mature thymic tissue and prominent Hassal’s corpuscles suggesting thymolipoma. There was no evidence of malignancy.

To characterize the radiologic features of thymolipoma.Twenty-seven cases of thymolipoma were reviewed. Clinical, radiologic, and pathologic findings were noted.The masses occurred in 15 male and 12 female patients (mean age, 26.7 years). All 27 tumors were in the anterior mediastinum; 22 were in the anterior inferior mediastinum. On frontal radiographs, 12 tumors simulated cardiomegaly. On lateral radiographs, 12 tumors draped over the ipsilateral hemidiaphragm, simulating diaphragmatic elevation. Computed tomographic scans (n = 11) demonstrated a mixture of fat and soft-tissue attenuation in 10 tumors corresponding to adipose and thymic elements found at microscopy. Magnetic resonance images (n = 2) demonstrated fat and soft-tissue signal intensity characteristics. Both types of studies showed a connection between tumor and thymus.Thymolipomas are anterior mediastinal masses that may conform to the shape of adjacent structures. The diagnosis is supported by imaging studies that demonstrate fat and soft tissue within the tumor.

A 58-year-old woman was admitted to the hospital because of an abnormal shadow on chest X-ray, film, which was pointed out at a medical checkup, though she had no complaint. CT scan revealed a tumor corresponding to fat CT value at the anterior mediastinal region, and an operation was performed under a diagnosis of mediastinal lipoma. The resected specimen weighed 340g without surrounding infiltration. Pathological examination showed that the tumor was thymic lipoma. Thirty-six cases of thymic lipoma have been reported in Japan so far. There were 13 males and 23 female, with an averaged age of 36.6 years. This disease was often asymptomatic and commonly detected at medical checkup. Five patients were complicated by Myasthenia gravis. In the diagnosis of this disease CT scan is useful. Recently this disease has been increasingly seen in the literature and been considered not so rare as before. A recent widespread use of CT may contribute to this tendency.

A 50-year-old man was seen at the hospital because of dyspnea. Chest X-ray film indicated an abnormal mediastinal shadow. CT scan and MRI demonstrated the antrior mediastinal mass from the thymus and the CT number was -119 H.U. indicating fatty tissue. The preoperative diagnosis was thymolipoma. Under thoracotomy the tumor was extirpated. The tumor was 20cm× 24cm×4cm in size and 875g in weight and it was microscopically composed of normal thymic tissue and mature fatty tissue. The postoperative histological examination revealed thymolipoma. Postoperative course was uneventful. The patient has a disease-free period for one year and 8 months after the operation. In postoperative diagnosis of thymolipoma the value of CT and MRI indicating the localization and property of the tumor is emphasized.

Thymolipoma, a rare benign mediastinal tumor, was found in a 6-year-old boy. Computed tomography scans, magnetic resonance imaging, and angiography of internal thoracic artery confirmed the diagnosis before surgery.

Thymolipoma is a very rare benign neoplasm of the thymus. We present the case of a 42-year-old male with a massive mediastinal tumor discovered on a chest X-ray after a motorcycle accident. The patient had no complaints, and his physical examination was unremarkable. Chest CT scans revealed a lipomatous mass containing areas of soft tissue density. The patient was submitted to median sternotomy expanded to left anterolateral thoracotomy, resulting in the complete excision of the tumor. The pathological diagnosis was thymolipoma. Thymolipoma usually attains enormous dimensions by the time of diagnosis, and the occasional symptoms are related to compression of adjacent structures. Surgical resection is the treatment of choice and offers the only possibility of cure. The airway deserves special care during anesthesia induction.

The pathogenesis of thymolipoma is controversial and unclear despite numerous reports. A case report of thymolipoma with cytogenetic analysis is herein presented. The lesion demonstrated a translocation involving the HMGA2 gene on chromosome 12q15, which is seen in two thirds of solitary lipomas. This finding supports the theory that this case of thymolipoma is a neoplasm of thymic fat.

A 52-year-old male presented with an anterior mediastinal tumor associated with a 2-year history of myasthenia gravis. The patient underwent thymectomy and a 185-g, 10 X 8 X 3.5 cm, well-delineated tumor was resected. On histologic examination the tumor proved to be a thymolipoma composed of mature adipose elements containing cords and nests of thymic tissue. The latter consisted mainly of cortical areas, the thymocytes of which displayed an immunohistochemical profile of cortical cells, i.e., CD 1+, CD 4+, CD 8+, and frequently Ki 67+. Ultrastructural study confirmed the predominant cortical differentiation of the thymic component. No germinal centers, dendritic reticulum cells, or myoid cells were detected by histologic, immunohistochemical, and ultrastructural studies. The association of thymolipoma with myasthenia gravis is rare; this case is the 10th reported. Our findings lead us to believe that (a) the cortical differentiation of the thymic component and the active thymocyte proliferation could represent a factor leading to myasthenia gravis; and (b) thymolipoma could be a peculiar form of thymoma rather than a mixed tumor of mesenchymal and entodermal origin, a lipoma, or a hamartoma of the thymic gland. The reported association of thymolipomas with other immune disturbances or with neoplastic conditions usually associated with true thymomas support these findings.

Thymolipoma is a very rare benign anterior mediastinal tumour. Most patients are asymptomatic but a few may present with clinical symptoms attributable to its huge size or less frequently, with myasthenia gravis. We report a case of huge thymolipoma occupying almost two thirds of the thorax in a 25-year-old female, which caused collapse of the lower lobe of the left lung simulating cardiomegaly on a chest skiagram. The tumor was successfully removed en bloc through a median sternotomy combined with an extended left anterolateral thoracotomy. There was no clinical or radiological evidence of residual tumor at the 1-year follow-up.

Thymolipoma is a very rare, benign mediastinal tumor. In this paper, we report on the thoracoscopic resection of such a lesion in a 4-year-old girl.

Thymolipomas are unusual benign neoplasms composed of mature adipose and thymic tissue that represent less than 10% of all thymic tumours in man. A thymofibrolipoma is a histological variant of thymolipoma in which there is an additional abundance of fibrous connective tissue. Thymolipoma has been reported previously in one dog and one cat, but thymofibrolipoma has never been described. This report documents the clinical and pathological features of two cases of canine thymofibrolipoma.

Thymic carcinoma arising within a thymolipoma has not been reported previously. The authors present a unique case of thymoma and undifferentiated thymic carcinoma arising within a thymolipoma in a 36-year-old woman. The bulk of the resected mass was composed of benign fatty tissue admixed with foci of unremarkable thymic tissue; however, it also harbored a central solid mass showing undifferentiated thymic carcinoma associated with a type B2 thymoma. The carcinoma cells were positive for cytokeratin AE1/AE3, cytokeratin 19, and cytokeratin 8/18. They were negative for vimentin, cytokeratin 7, cytokeratin 20, CD5, epithelial membrane antigen, CD30, placental alkaline phosphatase, carcinoembryonic antigen, CD99, leukocyte common antigen, Epstein-Barr virus, inhibin alpha, and protein gene product 9.5. Rare tumor cells showed positive staining for chromogranin and synaptophysin.

Thymolipoma is a benign tumour composed of thymic elements and adipose tissue. It may be associated with myasthenia gravis or immune disorders. We aimed to evaluate the clinical and radiological features of thymolipoma. The clinical data from 10 cases of thymolipoma, diagnosed at our centre between 2002 and 2004, were analysed retrospectively. There were six female and four male patients, whose ages ranged from 16 to 67 years, with a mean age of 34.1 years. All but two patients had pulmonary or extrapulmonary symptoms. Five patients also had myasthenia gravis. All thymolipomas were localized in the anterior superior mediastinum. The surgical approach was sternotomy in nine cases and thoracotomy in one case. Thymectomy was performed on all patients. Thymolipomas are unusual tumours and may be associated with myasthenia gravis. Surgical resection is the most appropriate treatment modality.

A 51-year-old woman with a 3-year history of diplopia was admitted to our hospital. Repetitive stimulation of the right median nerve revealed decreasing hand muscle responses. Edrophonium chloride administration alleviated the symptoms. The serum antiacetylcholine receptor antibody level was 3.3 nmol/l; thus, myasthenia gravis was diagnosed. A chest roentgenogram revealed a left inferior mediastinal mass, and a chest computed tomographic scan revealed a fat density mass partly containing soft tissue areas in the left side of the anterior mediastinum. Median sternotomy and extended thymectomy were performed. The pathology examination of the tumor revealed mature adipose tissue including islands of thymic tissue containing Hassall's corpuscles, without germinal centers. The tumor was a thymolipoma of the anterior mediastinum. Her postoperative course was good, and she is doing well at 1 year postoperatively.

A massive anterior mediastinal tumor was discovered in a 9-year-old girl with long-standing symptoms of asthma. Preoperative computed tomography (CT) scan and magnetic resonance imaging (MRI) results suggested the presence of a thymolipoma, a rare benign tumor of the thymus. Few cases have been reported in the literature, although the histological and radiographic features have been well described. This case confirms previously reported characteristics and also illuminates new aspects of clinical presentation and perioperative management.

Thymus is a principally lymphoid organ located in anterosuperior mediastinum and one of the main elements of the immune system. Most common thymic tumours are thymomas, but other types such as lymphomas, thymolipoma, germ cell tumours, cysts, and neuroendocrine carcinomas may also arise in thymus. Here we are presenting a case of huge thymolipoma with unusual presentation of being asymptomatic. On English literature search we found only three such case reports and none from Indian Institutes.

The authors present the case of a 29-year-old woman with a massive anterior mediastinal tumor who presented with respiratory distress since 1 month. A thoracic computed tomographic scan suggested a mediastinal lipomatous mass, and an operation was performed via median sternotomy. Resection of the tumor resulted in immediate improvement in the patient’s pulmonary status, and the histopathologic examination revealed thymolipoma. Because thymolipoma can attain enormous dimensions and compress adjacent structures, it should be immediately resected.

The authors present the case of a 40-year-old female with a massive anterior mediastinal tumor who presented with acute respiratory distress. She required emergent intubation and ventilatory support for respiratory compromise caused by lung compression. Preoperative computed tomographic scan results suggested a mediastinal lipomatous mass. Resection of the tumor resulted in immediate improvement in her pulmonary status. Because thymolipomas can attain enormous dimensions and compress adjacent structures, they should be resected at the time of diagnosis.

Thymolipomas are rare benign thymic neoplasms recognised in humans, composed of mature adipose tissue and thymic tissue. An 8-year-old male domestic shorthair cat presented with anorexia, lethargy and vomiting secondary to the development of a thoracic effusion and an anterior mediastinal tumoral mass with fatty appearance. Histologically, the mass consisted of adipose tissue containing numerous cords and nests of cortical and medullary thymic tissue. No signs of thymic epithelial or lymphoid neoplastic proliferation were detected. The findings in this case are remarkably similar to the macroscopic and histological features of thymolipoma in humans.

Thymolipoma is a rare tumor composed of both adipose and mature thymic elements which may grow to very large sizes before becoming symptomatic. Since thymolipomas are benign tumors and do not invade adjacent structures, a plane of dissection can readily be developed during surgical resection. We report a large tumor involving both thoracic cavities which was successfully excised from a left thoracotomy incision with preservation of adjacent nerves and blood vessels.

We report a case of a huge mass located at the anterior – superior mediastinum in a 2 – year – old black girl. The patient had no symptoms or any other associated disease. Preoperative examination was performed using chest CT scan and chest MRI, and sugested the diagnosis of thymolipoma before surgery. This tumor was successfully resected by an anterior bilateral thoracotomy with sternotomy (Clamshell incision). The diagnosis was confirmed histologically. Thymolipoma is a rare benign mediastinal tumor that can be presented as very large tumor in an asymptomatic patient, or it can be associated with myasthenia gravis, amyotrophic lateral sclerosis, red cell aplasia, hypogammaglobulinemia and lichen planus, especially in adults. Reportamos o caso de uma tumoração volumosa localizada no mediastino anterior superior em uma criança do sexo feminino, negra, de 2 anos de idade. A paciente estava assintomática e não apresentava doenças associadas. Foi realizada avaliação pré-operatória usando a tomografia computadorizada e a ressonância nuclear magnética do tórax, que sugeriram o diagnóstico de timolipoma. Este tumor foi tratado cirurgicamente por uma toracotomia bilateral com secção transversa do esterno (incisão à Clamshell). O diagnóstico foi confirmado pela histopatologia. O timolipoma é um tumor raro do mediastino anterior que pode apresentar-se como uma grande massa em um paciente assintomático bem como associado com miastenia gravis, esclerose lateral amiotrófica, aplasia medular, hipogamaglobulinemia e liquen plano, entidades estas presentes principalmente nos adultos.

A 48-year-old woman with an abnormal shadow in chest radiography during an annual physical examination was found by chest computed tomography to have a large fatty mass lesion found to be diagnosed as a gigantic lipoma. Histopathological diagnosis was found to be benign thymolipoma consisting of mature fatty tissue and hyperplastic thymic tissue structures with Hassall,s corpuscles. Although the diagnosis is supported by imaging studies that demonstrate fat and soft tissue within the tumor, variations occur in computed tomography appearance. We suggest that surgical excision be considered when a gigantic intrathoracic lipomatous mass is in scanning as in this case.

A 26-year-old man presented with shortness of breath on exertion that was gradually getting worse. His history revealed a mass in the left hemithorax that had been growing on follow-ups. Physical examination only showed that the respiratory sounds were fainter on the left. Thoracic computerized tomography was performed to elucidate the left hemithorax lesion seen on chest x-ray and a giant mass of lipid density extending from the anterior mediastinum to the diaphragm and filling almost the entire left hemithorax was observed. Total excision of the 25 × 21 × 8 cm mass weighing 1580 g was performed with a left thoracotomy. The histopathology investigation of the mass was reported as thymolipoma. The case was presented because it is a rare mediastinal mass.

We report a case of a 11-year-old boy who presented with a massive soft tissue right cervical painless and progressive lesion displacing trachea to the left and extending into the anteriosuperior mediastinum which was diagnosed to be a lipomatous mass on chest CT scan. Subsequent biopsy and total excision proved it to be a giant cervicomediastinal thymolipoma. It was successfully excised with excellent prognosis and long-term results. A giant paediatric cervicomediastinal thymolipoma is a rare, benign, mediastinal mass of thymic origin. It may remain asymptomatic despite massive size and up to 50% in some series are associated with autoimmune disease. CT scan gives fat density and encapsulated benign nature and biopsy usually establishes the diagnosis. Preoperative tissue diagnosis is important as now the availability of thoracoscopic option is best suited to reduce morbidity. Treatment of choice is total excision using open surgical, minimal invasive techniques or robotic surgery and the prognosis is excellent.

We report a case of a thymic neoplasm in an 18-year-old woman who presented with chest discomfort and an anterior mediastinal mass. The surgically resected tumor showed abundant adipose tissue admixed with thymic tissue and numerous medium-caliber blood vessels. We consider this tumor a rare variant of thymolipoma and designate it as thymohemangiolipoma. Because of its benign nature, it should be distinguished from other mediastinal lesions. Ann Diagn Pathol 4:236-239, 2000.

Thymolipoma is a rare benign tumor of the thymus. Because of its large size and pliability the mass usually drapes itself around the heart, conforming to its borders and producing a large radiographic shadow easily mistaken as cardiomegaly. This report describes a 48-year-old man with a chest radiograph strongly suggestive of cardiomegaly. Careful radiological study showed the existence of a large mass in the anterior mediastinum, simulating cardiomegaly. A thymolipoma weighing 2500g was resected through an esternotomy.

Se presenta un caso de timolipoma mediastínico en un paciente de 14 años portador de asma bronquial, pesquisado durante el control de una crisis bronquial obstructiva. El diagnóstico de este tumor fue planteado por las imágenes en la Rx de tórax y por la tomografía axial computarizada (TAC) previo a su extirpación quirúrgica. No hubo síntomas atribuibles a este tumor, como tampoco disminución en los volúmenes pulmonares a pesar de la gran masa que contenía el tórax. Al extirparlo se comprobó un peso de 1 200 g y el estudio histológico confirmó la sospecha planteada por la característica en la Rx y TAC de tórax We present a case of a thymic lipoma in a 14 year old patient with bronchial asthma. The tumor was diagnosed during an obstructive bronchial crisis, in which a chest x-ray and a CT chest scan were performed. The patient did not have symptoms from the tumor, even though it was a large mass weighing 1.200 g. Histological examination of the tumor confirmed the clinical diagnosis

Thymic neoplasms are a common cause of an anterior mediastinal mass and may be benign or malignant. Thymic cysts are congenital or acquired and may be associated with a thymic malignancy. True thymic hyperplasia and thymic lymphoid hyperplasia may enlarge the thymus and simulate a neoplasm. Thymoma and thymic carcinoma are epithelial malignancies with distinct clinicopathologic features. Thymic carcinoid is a rare aggressive neuroendocrine malignancy associated with multiple endocrine neoplasia 1. Thymolipoma is a benign neoplasm. Hodgkin and non-Hodgkin lymphoma may primarily or secondarily involve the thymus. Primary mediastinal germ cell tumors may arise primarily within the thymus and include mature teratoma, seminoma, and non-seminomatous malignant germ cell tumors.