Fig. 1

Chest CT scan (plain and contrast-enhanced) before treatment on june 3, 2023 A: Multiple nodules and irregular patchy soft tissue masses in the anterior and left anterior mediastinum (mediastinal window); B: Multiple nodules and irregular patchy soft tissue masses in the anterior and left anterior mediastinum (lung window)."

Fig. 2

PET/CT scan before treatment Irregular soft tissue density masses observed in the anterior and left anterior mediastinum with low glucose metabolism, highly suggestive of thymoma. Pathological correlation is recommended for definitive diagnosis. SUV: Standardized uptake value."

Fig. 3

Mediastinal mass biopsy Microscopic appearance of thymoma showed spindle cells and thymic lobules containing lymphocytes (H-E staining, ×200)."

Fig. 4

Preoperative chest CT scan and contrast-enhanced images (October 17, 2023) A: Giant left anterior mediastinal thymoma (mediastinal window); B: Giant left anterior mediastinal thymoma (lung window)."

Fig. 5

Postoperative chest CT scan and contrast-enhanced images (November 14, 2023) A: Left anterior mediastinal mass is no longer visible; left pleural effusion and pneumothorax formation (mediastinal window). B: Left anterior mediastinal mass is no longer visible; left pleural effusion and pneumothorax formation (lung window)."

Fig. 6

Mediastinal mass (measuring 14.9 cm×6.6 cm×6.7 cm)"

Fig. 7

Bone marrow aspiration and biopsy Microscopic examination reveals bone trabeculae and marrow tissue. Trilineage hematopoietic cells are present, with granulocytic series hyperplasia and erythroid series hypoplasia (H-E staining，×200)."