An anterior mediastinal mass can comprise a wide variety of benign and malignant tumours that can present with diverse clinical symptoms. Diagnosis often requires multiple imaging modalities along with laboratory tests and, in specific cases, tissue biopsies. Upfront tumour resection is often preferred in cases with a substantial suspicion of malignancy whenever complete resection is deemed possible.

Abstract

We present a relatively common case of a substantial anterior mediastinal mass with a high suspicion of thymoma in a 73-year-old male patient without myasthenia gravis. Based on his computed tomography scan, a 3-dimensional model was built. Upfront resection without neo-adjuvant therapy was deemed feasible and therefore preferable. A DaVinci robot-assisted 3-port resection of the tumour was performed from the patient’s left side. The intra- and postoperative courses were uneventful, after which the patient was discharged home on postoperative day 3.

Introduction

Robotic-assisted removal of tumours from the anterior mediastinum, oftentimes thymomas, is an elegant and safe method to achieve an oncological complete resection. Depending on the anatomical features of the patient and the tumour, a left- or right-sided approach can be taken to identify and dissect the complete area between the two phrenic nerves. Anterior mediastinal masses can comprise a wide variety of different tumours. Location, radiological features and clinical signs often narrow the differential diagnosis in the absence of or prior to tissue biopsy [1]. The Maastricht University Medical Centre in Maastricht, the Netherlands, is an experienced Dutch expertise centre connected with EURACAN for the treatment of thymomas [2]. A relatively common case is presented in which a left-sided approach was taken, resulting in complete and radical dissection of an AB type thymoma.

Surgical Technique

© The Author 2025. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

https://pubmed.ncbi.nlm.nih.gov/40522261/

Romeo J, Maessen J, Segers P, Marcuse F, Hochstenbag M, Gietema H, Lalji U, Abdul Hamid M, Qiu S. Robotic resection of thymoma recurrence with intrathoracic phrenic nerve reconstruction using a sural nerve graft: a case report Mediastinum, 2025