Subxyphoid thoracoscopic thymectomy in a patient with the location of the left brachiocephalic vein in the thickness of a cystically altered thymus gland: clinical observation and literature review

Thymic neoplasms are rare in prevalence among the general population. The most common benign formation of the anterior mediastinum is thymus cyst, while thymoma is the most common malignant tumor of the mediastinum. An important problem in mediastinal surgery is the need to exclude a malignant process in a complex thymic cyst or in a hyperplastic thymus, because autoimmune processes in the body are accompanied by changes in the thymus gland. In half of the cases, thymomas can be associated with pathognomonic autoimmune syndromes (myasthenia gravis, Hood syndrome, red cell aplasia). We present a clinical case of a complex multicameral thymic cyst with the unique location of the left brachiocephalic vein in the thickness of the thymus parenchyma. No data has been obtained for the presence of a malignant process or myasthenia. Due to the large size of the tumor and the high location of the main part of the neoplasm, the surgical operation was performed from a subxyphoid approach. No data have been obtained for postoperative complications, including relaxation of the diaphragm. © 2025 Elsevier B.V., All rights reserved.