Cavernous hemangioma in the thymus: a case report

Abstract

Cavernous hemangioma is not a neoplasm, but rather a congenital venous malformation with the potential to develop in all parts of the body, though it is very rarely seen in the thymus. We report a case of cavernous hemangioma in the thymus partially resected. A 71-year-old woman presented with pericardial discomfort, and chest computed tomography (CT) showed a left lateral mediastinal mass which was 2.0 × 1.2 × 1.8 cm in size, with border regularity and without calcification. Its interior was partially enhanced. Three-dimensional chest computed tomography image showed a tortuous vessel connecting to the tumor. Surgical resection was performed for the purpose of providing a definitive diagnosis and treatment because a mediastinal tumor such as thymoma or teratoma was suspected. Partial resection of the thymus including the mass was done by utilizing a three-port, left-sided video-assisted thoracic surgery (VATS) approach with hoisting of the third rib with the patient in a spinal position. A wine-colored mass bulging from the surface of the left lobe of the thymus was identified along with the communicating vessel which could only be cut with an energy device. It is considered that thymic partial resection using VATS is a better option for small and non-infiltrative lesions.

CT and MRI manifestations of mediastinal cavernous hemangioma and a review of the literature

“…Previous studies generally used 30-s first phase and 120-s delayed phase scanning project after contrast agent was injected [9]. In addition, dilated malformed drainage veins connected with the brachiocephalic vein and superior vena cava in the lesions were found after contrast agent was injected in five cases of the anterior mediastinum, which was consistent with the feature found by some scholars [9, 10]. In this group, blood vessel shadows were found in T1WI of one lesion, yet this phenomenon has not been reported in the past.…”

Rare case of cavernous hemangioma of the thymus

“…Imaging examinations including chest CT scan and magnetic resonance imaging (MRI) are beneficial for assessing the tumor size, border and vascular condition but they don't allow to determine whether a mass is benign or malignant. Enhanced CT may be very effective, as it can reveal a phlebolith in some cases of venous malformation [4,7]. In our case, we noticed a thin peripheral calcification on CT scan.…”

“…Indeed, there is a risk of bleeding by biopsy of the mass. Also, it is difficult to distinguish CH from other tumors of the mediastinum such as a thymoma [7,8]. Thus, a CH requires often a resection for diagnosis and treatment.…”

“…Thus, a CH requires often a resection for diagnosis and treatment. Histopathological findings generally show cavernous or cystic venous channels with a flat single layer of endothelial cells without atypia or mitosis [7].…”

Cavernous hemangioma of the thymus

“…Median sternotomy or thoracotomy could be suitable for cases with a giant tumor or innominate vein aneurism. [ 10 ] On the other hand, with the development of minimally invasive technology, most small and noninfiltrative thymic tumors could be safely and availably excised via video-assisted thoracoscopic surgery (VATS). Shen et al [ 3 ] described the case of a 52-year-old male who underwent thymectomy using VATS.…”