Radical surgery and combination chemotherapy: An aggressive approach to the treatment of metastatic thymoma

A 48-year-old man presented with venous distension over the chest wall. Computerised tomographic imaging revealed an anterior mediastinal mass and a left adrenal mass. At operation, a large mediastinal mass with extensive invasion into surrounding structures, a non-contiguous sternal metastasis, and a left adrenal metastasis were found. Analysis of frozen section confirmed metastatic thymoma. Aggressive surgical resection of primary and metastatic lesions was undertaken, followed by adjuvant chemotherapy with cisplatin, adriamycin and cyclophosphamide. Despite the presence of haematogenous metastatic disease, the patient was free of disease 36 months later. This case offers support for a policy of aggressive surgical and chemotherapeutic treatment in disseminated thymoma.