CTICasesThymoma (B3) with Intraperitoneal and Pelvic Drop Metastases
Imaging findings
CT in a patient with a prior pleurectomy for B3 thymoma shows new liver metastases, peritoneal seeding, and multiple drop metastases in the pelvic floor, representing unusual intra-abdominal dissemination of thymoma.
Key takeaways
Thymomas, particularly higher-grade types (B3 and thymic carcinoma), can metastasize hematogenously or via pleural and peritoneal seeding. Drop metastases in the pelvic floor from thymoma are rare and likely occur through diaphragmatic lymphatics or direct seeding during prior thoracic surgery. This represents an important pattern to recognize, as it changes surgical and systemic treatment planning.
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