Spontaneous rupture of a giant thymoma causing hemothorax and cardiopulmonary collapse.

Spontaneous rupture of a thymoma is a rare event. An 81-year-old female presented with an asymptomatic 14-cm thymoma in the mid-upper mediastinum, extending to the right diaphragm for thymectomy. Two days before surgery, she developed acute dyspnea and chest pain. Admission chest roentgenogram showed a new large right pleural effusion. Thoracoscopic drainage of 2200 mL of blood mixed with necrotic tumor debris revealed a posterior rupture of her thymoma. The mass was resected via median sternotomy, and the chest irrigated. Her postoperative course was uneventful. Final pathology showed Type A thymoma with an 8-cm perforation, with ruptured intratumoral and capsular veins.