Robotic-Assisted Extended Thymus Carcinoma Resection With Unilateral Total Pleurectomy and Hyperthermic Intrathoracic Chemotherapy (HITOC).

Thymic squamous cell carcinoma (SCC) is an aggressive form of thymic cancer that is often diagnosed at an advanced stage. Hyperthermic intrathoracic chemotherapy (HITOC) is a treatment option for advanced thoracic and especially pleural malignancies, though it is not yet the standard of care. However, the success of treating pleural cancers with HITOC protocols has been well documented in selected cases. Robotic-assisted thoracoscopic surgery (RATS) has become the standard procedure for thymectomy, even for locally advanced tumors. In this report, we describe the treatment of a 53-year-old patient with a locally advanced Masaoka-Koga stage IVa thymic SCC and concomitant limited pleural carcinomatosis who was successfully treated by RATS thymectomy and HITOC. The report highlights the diagnostic challenges, therapeutic approach, and postoperative care, emphasizing the advantages of minimally invasive, robot-assisted surgery even in advanced cases. RATS with HITOC can be a safe and effective method for the treatment of advanced thymic carcinoma. This case report demonstrates that this procedure enables rapid postoperative recovery and can be performed with minimal morbidity.