PMC9722296_01
(a) Axial and (b) coronal computed tomography of the thorax showing a tumour invading the right lung, occupying most of the right hemithorax, and crossing the midline to the left side of the mediastinum. (c) 18F-fluorodeoxyglucose positron emission tomography integrated with computed tomography showing heterogeneous radiotracer uptake in the tumour, with maximum standardized uptake value of 13.1 and areas of photopenia.
CRIS2022-9604926.001.jpg
PMC9722296_01_CRIS2022-9604926.001.jpg
fig1
This finding was further investigated with thoracic computed tomography (CT), which demonstrated a lobulated, heterogeneous mass measuring approximately 22.5 cm in craniocaudal dimension, occupying most of the right hemithorax and crossing the midline to the left side of the mediastinum (Figures 1(a) - 1(b)). A subsequent 18F-fluorodeoxyglucose positron emission tomography (PET) integrated with CT did not show evidence of metabolically active lymph nodes, separate foci of radiotracer uptake in the pleura or pericardium, or extrathoracic disease (Figure 1(c)).
Giant thymoma resected en bloc with the right lung and ipsilateral parietal pleura. The specimen measured 236 mm x 214 mm x 114 mm.
CRIS2022-9604926.002.jpg
PMC9722296_01_CRIS2022-9604926.002.jpg
fig2
A right exrapleural pneumonectomy was performed, and the thymoma was removed en bloc with the lung (Figure 2).
Intraoperative image following resection of an invasive thymoma with right extrapleural pneumonectomy, reconstruction of the superior vena cava and left brachiocephalic vein with expanded-polytetrafluoroethylene grafts, and replacement of the pericardium with an expanded-polytetrafluoroethylene mesh.
CRIS2022-9604926.003.jpg
PMC9722296_01_CRIS2022-9604926.003.jpg
fig3
Gore & Associates) mesh (Figure 3).