Clinical case report of gigantic thymolipoma in 3-year-old child

Abstract

Thymolipoma is a rare benign encapsulated tumor of anterior mediastinum. Overall, thymic neoplasms comprise only 4% of all mediastinal tumors. Only 2–9% of these are reported to be thymolipomas. Less than 200 cases have been published in the world literature and its incidence in both genders is equal and usually develops at any age. The youngest case in the literature was described in 6-month-old child. Thymolipoma can be associated with chronic lymphocytic leukemia, myasthenia graves, aplastic anemia, hyperthyroidism and Hodgkin’s disease. Half of the patients are asymptomatic, the neoplasm incidentally is discovered radiologically. The other half mostly represents shortness of breath, cough, chest pain and upper respiratory tract infection. The clinical case, diagnosis and treatment of gigantic thymolipoma in 3-year-old child is described in this article. A clinical case of giant thymolipoma in a 3-year-old child is presented. The child had several respiratory symptoms: episodes of choking, dry cough, groaning breathing during physical exertion and anxiety, chest deformity (enlarging the right half) and signs of type II respiratory failure. Radiographically - subtotal darkening of the right hemithorax with mediastinal shift to the contralateral side with compression of the left lung; laboratory results - hyperleukocytosis(39х109/l). Computed tomography showed a large hypovascular mass formation with inhomogeneous structure and areas of lipomatosis. Most likely, this is the case of congenital nature of thymolipoma, which manifested itself at the age of 3. Correct pathomorphological diagnosis was made with the help of open biopsy, since when performing the puncture method, there is a possibility of verification error due to insufficient amount of histological material given the inhomogeneity of the mass of the formation, as well as taking into account the suspicion of a lymphoproliferative process. Considering the mediastinal and intrathoracic compression syndrome, as well as the benign nature of these tumor, which is characterized by the absence of infiltrative growth, the only correct treatment tactic is radical surgery. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: neoplasms of anterior mediastinum, thymolipoma, children.