We present the case of a 57-year-old man with ataxia and clinical and radiological features of cerebellar degeneration. A computed tomography showed a mediastinal mass. The patient was diagnosed of thymic carcinoma. paraneoplastic cerebellar degeneration is an unfrequent disorder, and its association with thymic carcinoma is very rare.
Mediastinal tumours can be incidental findings on chest x-ray or present with systemic symptoms and/or direct effect of the mediastinal mass. We report the case of a woman with symptomatic thymoma B1 and simultaneous thymus tuberculosis.
Introduction: Thymic clear cell carcinoma is the most uncommon subtype of thymic carcinoma, with 20 cases reported worldwide.
Case Description: We present the case of a 61-year-old female with dyspnoea and chest pain for 2 days. Computed tomography (CT) angiography showed pulmonary thromboembolism and the existence of mediastinal and bilateral hilar lymphadenopathy, the largest infracarinal with an inferior axis of 25 mm, and also, micronodules on the left pulmonary parenchyma. The patient was admitted for aetiological assessment and underwent anticoagulant therapy. After a month, she had an ischaemic stroke, the sequelae of which proved to be fatal. The autopsy showed a mass in the superior-anterior mediastinum, with dimensions of 11×8×6 cm, corresponding to a thymus signet ring cell primary carcinoma. The immunohistochemistry study revealed that this mass was positive for AE1/AE3, CK5/6 and CK7.
Conclusion: The clinical, morphological and immunophenotypic diversity of this tumour makes its diagnosis a difficult multidisciplinary challenge, which requires a high level of clinical knowledge and accurate imaging and histological investigation.