A case of concomitant surgery of invasive thymoma and aortic valve insufficiency

A 73-year-old man was referred to our hospital for treatment of a mediastinal tumor and aortic valve insufficiency. Chest CT revealed an anterior mediastinal tumor and pericardial effusion, which was believed to have occurred due to previous heart failure. The mediastinal tumor was diagnosed as a thymoma based on findings of CT-guided biopsy. The tumor had invaded the patient's left brachiocephalic vein and had disseminated in the pericardial space with bloody effusion. Aortic valve replacement was performed after resection of the tumor and disseminated lesion. The pathological diagnosis was a Type B3 thymoma based on the WHO classification. Although the patient died of pneumonia 33 months after the operation, his condition up to that point had been good and he did not have symptoms of heart failure. There was no case has been reported previously in which simultaneous operations were performed for aortic regurgitation and invasive thymoma with intrapericardial disseminations.