case_images: PMC9907031_01
case_images: Imaging of the mediastinal neoplasm at CT scan and at FDG-PET scan. The mediastinal mass of 81x73x54mm (red circle) at CT-scan (A). FDG-PET scan: a focal hypermetabolism with SUVmax 11.30 (white arrow) within negative surrounding tissue (B). Advanced prostatic adenocarcinoma with multiple metastases at the thoracic vertebrae, femur, sacrum and within the mediastinal lesion (black arrows) (C, D).
case_images: cureus-0015-00000033537-i01.jpg
case_images: PMC9907031_01_cureus-0015-00000033537-i01.jpg
case_images: FIG1
case_images: An FDG-PET confirmed hypermetabolic spots in the femur, in the dorsal spine and showed an intense uptake enclosed in a limited area within the parasternal malignancy, suggesting a possible thymic carcinoma (Figure 1).
case_images: Pathologic specimen. Panoramic overview at 100x magnification, showing multinodular growing pattern and the clear area corresponding to the prostatic carcinoma metastasis (right, A). Classical type A thymoma (B). Prostate cancer metastasis (C ). Detail showing metastatic tissue (right) with the thymoma component (left), (D). Immunostain of the area showed in D with PSA and racemase that highlight prostatic tissue (E and F, respectively), and with p63 that highlight thymoma. B,C,D,E,F original magnification 200x.
case_images: cureus-0015-00000033537-i02.jpg
case_images: PMC9907031_01_cureus-0015-00000033537-i02.jpg
case_images: FIG2
case_images: Clear areas were frankly evident within the tumor (Figure 2A). The level of atypia was minimal and only scattered mitotic activity was noted (Figure 2B). Immunohistochemically, the tumor cells were positive for AE1-AE3 keratins and to p63 (Figure 2G). Clear areas showed completely different histological features with atypical epithelioid cells, clear amphophilic cytoplasm, enlarged nuclei, and prominent nucleoli (Figure 2C, 2D). A thymoma was staged as pT1aN0 (Stage I). According to the clinical history of the patients, prostatic markers such as PSA and racemase were tested and resulted in producing a strongly positive observation only within the clear areas, confirming the prostatic origin of the cells (Figure 2E, 2F).