A Case of Mediastinal Hodgkin's Disease with Giant Thymic Cyst

Abstract

Background. We report a rare case of mediastinal Hodgkin's disease associated with a large thymic cyst. Case. A 23-year-old woman was found to have an abnormal shadow on a chest X-ray obtained during a pre-employment health check in March 2007. A chest CT showed a large anterior mediastinal mass, for which she was referred to our hospital. The mass comprised a solid part with a contrast effect and a cystic part with no contrast effect. There was no invasion into the surrounding tissue. For purposes of diagnosis and treatment, an extended thymectomy was performed via a median sternotomy in April 2007. During surgery, adhesion (to the mass) to the left branchiocephalic vein and the right phrenic nerve was observed. It was possible to separate these tissue and to perform a complete resection. Histopathology revealed that the tumor was Hodgkin's disease associated with a thymic cyst. After surgery, the patient was treated with ambulatory chemotherapy, and she has not shown signs of recurrence. Conclusion. When a multilocular thymic cyst is observed, it is necessary to consider a possible association with a malignant tumor.