Resection of a micronodular thymoma with lymphoid stroma achieved by robot-assisted thoracic surgery (RATS): a case report

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Background: Thymoma is a rare malignant tumour in adults which originates from thymic epithelial cells. Micronodular thymoma with lymphoid stroma is a rare subtype that accounts for about 1% of all thymoma cases. Due to the extremely limited number of reported cases, the clinical guidelines and therapeutic regimens have not yet been established. Case Description: A 83-year-old woman was referred to our hospital to investigate an undiagnosed anterior mediastinal mass. The mass was recognized incidentally due to further investigations related to unspecific chest pain. The computed tomography of the thorax showed a mass measuring 22 mm × 16 mm × 24 mm in the anterior mediastinum. The patient was completely asymptomatic except for the unspecific chest pain. A right sided robot-assisted thoracoscopic thymectomy was performed for diagnosis and treatment. The postoperative period showed no complications. The patient was discharged home three days after the operation. Histopathological examination showed a micronodular thymoma with lymphoid stroma Masaoka Stadium II. Conclusions: It is feasible to perform robot-assisted thoracic surgery thymectomy for complete resection even if the preoperative histopathology is unclear. This rare subtype has a good prognosis if it is completely resected. It is a borderline tumour with no reports of recurrence, distant metastasis, or tumour-related deaths.

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