Extensive mediastinal thymolipoma mimicking pulmonary edema

Thymolipoma is a rare benign slow-growing encapsulated tumor of anterior mediastinum that accounts for 2–9% of all thymic neoplasms. About 30–50% of them are asymptomatic and found incidentally. Less than 200 cases have been published in the world literature so far. Here we report a case of thymolipoma of an adult female presented with progressive dyspnea, chest tightness and non-productive chough for 2-month duration. All blood investigations were normal. Radiological examinations suggested the presence of fat and soft tissue within the tumor without invading the neighboring structures. We concluded that the only curative treatment of thymolipoma is surgical excision. Unfortunately, the patient did not give consent despite telling her the outcomes if we do not do the surgical procedure, and a week later she passed away due to respiratory distress secondary to the mass effect of the tumor.