Asymptomatic Thymic Carcinoma With Solitary Hepatic Metastasis Detected by Fluorodeoxyglucose Positron Emission Tomography

Thymic carcinoma is a rare anterior mediastinal malignancy. Most patients present initially with chest pain, cough or dyspnea. Asymptomatic patients account for less than one third of the total cases. Thymic carcinoma is aggressive and tends to metastasize to the lymph nodes, lungs, and bones, and less commonly to the liver, spleen, brain, and adrenal glands. We present a 49-year-old man who received abdominal ultrasound and magnetic resonance imaging for a health checkup, during which, a necrotic hepatic tumor was found incidentally. Fluorodeoxyglucose (FDG) positron emission tomography was performed to search for the primary site of malignancy, and lobulated FDG hypermetabolic lesions in the anterior mediastinum were found. The diagnosis of thymic carcinoma with liver metastasis was then confirmed after morphological and immunohistochemical studies of hepatic and mediastinal biopsy specimens. ? 2009 Formosan Medical Association & Elsevier.