the most common sites of metastatic thymic carcinomas ( masaoka - koga stage ivb ) are the lung , liver and brain . they can be found in the kidney , pancreas , pituitary , orbital , lymph nodes , peritoneum , and the ovaries . 1 ) . according to the french rythmic guidelines , the patient underwent preoperative chemo - radiotherapy followed by a complete resection . parietal and pleural tumors were detected by ct scan and [ f]fdg - pet / ct in 2008 . the patient was reoperated , and these tumors were confirmed to be metastases of mixed thymoma b3 and thymic carcinoma . a pelvic mass was detected in 2013 by [ f]fdg - pet / ct ( suvmax 8.4 ) and confirmed by mri ( fig . a laparotomy confirmed an isolated peritoneal 60-mm tumoral mass localized on the left part of the douglas 's pouch . peritoneal and/or ovarian metastasis from thymic malignancies are very rare ; only four cases have been reported in the literature [ 2 , 3 , 4 ] . these metastases can occur immediately or several years after primary thymic tumor ( 36 years ) . different thymic histological subtypes were observed ( carcinoma , b1 , neuroendocrine ) , and they were always associated with a loco - regional extension and/or distant metastasis . to our knowledge , this is the first report of an isolated pelvic metastasis from thymic carcinoma . this isolated pelvic metastasis probably had a systemic origin rather than a direct peritoneal extension below the diaphragm ( as described in previously reported cases ) . however , considering that this pelvic metastasis was isolated and completely resected , chemotherapy was not performed in our patient . efficacy of [ 18f]fdg - pet / ct for the detection and localization of mediastinal recurrence is well established . our case report emphasizes the utility of [ 18f]fdg - pet / ct for metastasis detection and long - term follow - up in patients with thymic epithelial tumors .
thymic epithelial tumors are rare and often occur somewhere local . 
 metastatic sites of thymic carcinomas ( masaoka - koga stage ivb ) are mostly seen in the lung , liver and brain . 
 we report a 64-year - old female with an initial diagnosis of thymoma b3 who first showed thoracic recurrences and then an asymptomatic isolated pelvic metastasis from her thymic carcinoma .