• Cheng Fang, Hui Pan, Zhoubin Li, Shuang Lin, Liang Ma, and Weili Han.
• Department of Lung Transplantation.
• Medicine (Baltimore). 2019 Jul 1; 98 (28): e16385.

RationaleInvasive thymoma with intraluminal tumor thrombus may cause pulmonary artery thrombus if the tumor thrombus shed off during operation. However, there is no clinical case report focused on such complication.Patient ConcernsA 40-year-old woman presented with repeated chest pain.DiagnosisChest computer tomography showed huge mediastinal mass. Postoperative pathology revealed type B2 and B3 thymoma, with B3 as the main type.InterventionsThe patient underwent tumor resection through midline sternotomy in our hospital on September 17, 2018. She received emergent pulmonary artery exploration because the tumor thrombus in superior vena cava shed off unexpectedly during operation. Postoperative pulmonary computer tomography angiography showed right pulmonary artery embolism. Then emergent right pulmonary artery embolectomy was performed through lateral thoracic incision on September 29, 2018.OutcomesThe patient recovered well after surgery. D-dimer reduced rapidly and returned to normal 1 month after the second operation.LessonsIntraluminal tumor thrombus in invasive thymoma patients has a risk of shedding off during operation. Prevention strategy should be made beforehand. Pulmonary artery exploration is necessary once happened.

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