PMC9792865_01
Preoperative imaging. (A) Preoperative chest X-ray that highlights a mass in the left hemithorax, with a right dislocation of the heart. In the left hemithorax are also evident a left hemi-diaphragmatic elevation. (B) Preoperative CT scan showing a huge mass of the mediastinum dislocating the surrounding structures.
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During preoperative examinations for a planned cataract surgery in a 43-year-old male affected by DS, a chest X-ray was performed in November 2017, revealing a giant mediastinal mass invading the left hemithorax (Figure 1). The mass infiltrated the diaphragm and the pericardium, dislocating the heart, main airways, and esophagus, with a clear compression of the left main bronchus and the great mediastinal vessels (Figure 1).
Pathology. Hematoxylin-eosin, x10, type AB thymoma. Figure shows the two tumor's components, as well as immunohistochemistry for epithelial cells (CK-Pan) and lymphocytes (CD3, CD1a).
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Follow-up radiological imaging. (A) Post-operative chest X-ray. A normal X-ray profile is now evident, except for the elevation of the left hemidiaphragm. (B) Post-operative CT scan, showing the heart occupying its natural space. No disease recurrence can be detected. CI, computed tomography.
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The 3rd year chest X-ray and the subsequent CT performed according to the surveillance plan showed no signs of local or distal recurrences (Figure 3).