Unique case of atypical type A thymoma with vertebral metastasis and high 18‐fluorodeoxyglucose avidity.

Therefore, the differential diagnosis with other spindle cell neoplasms such as synovial sarcoma or fibrous solitary tumour was reconsidered, and only the immune-histo-chemistry allowed the final diagnosis of atypical type A thymoma.[1] This case, the first in our knowledge reporting vertebral metastasis from Atypical type A thymoma associated with very high 18-FDG uptake, opens some considerations about the behaviour and the management of this uncommon subtype of type A thymoma. Firstly, considering the different characteristics of the primary tumour and the vertebral metastasis, immunohistochemistry is mandatory to exclude another mediastinal spindle cell epithelial tumours, demonstrating that the fine needle histology may not be sufficient. [Extracted from the article]