{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T01:04:17Z","timestamp":1780016657055,"version":"3.53.1"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Typical type A thymomas are slow-growing tumors generally associated with a favorable clinical course, and distant metastasis is exceedingly rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a case of multiple lung metastases from a typical type A thymoma in a 74-year-old man, identified 9 years after the initial detection of an anterior mediastinal nodule. The patient underwent simultaneous thymectomy and wedge resection of the pulmonary nodule. Histopathological examination confirmed a diagnosis of typical type A thymoma with pulmonary metastases. Postoperatively, the patient was also diagnosed with prostate cancer as a secondary malignancy. At 2-year follow-up, without any postoperative treatment, there was no evidence of progression or development of new pulmonary lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case underscores the potential for distant metastasis in patients with otherwise indolent, typical type A thymomas, highlighting the need for long-term surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-026-04045-5","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T03:05:14Z","timestamp":1776308714000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiple lung metastases from typical type A thymoma after long-term follow-up: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Keita","family":"Tobari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Sano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"4045_CR1","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1097\/JTO.0000000000000654","volume":"10","author":"A Marx","year":"2015","unstructured":"Marx A, Chan JK, Coindre JM, Detterbeck F, Girard N, Harris NL, et al. The 2015 World Health Organization Classification of Tumors of the Thymus: Continuity and Changes. J Thorac Oncol. 2015;10:1383\u201395.","journal-title":"J Thorac Oncol"},{"key":"4045_CR2","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1016\/j.crad.2016.05.007","volume":"71","author":"A Khandelwal","year":"2016","unstructured":"Khandelwal A, Sholl LM, Araki T, Ramaiya NH, Hatabu H, Nishino M. Patterns of metastasis and recurrence in thymic epithelial tumours: longitudinal imaging review in correlation with histological subtypes. Clin Radiol. 2016;71:1010\u20137.","journal-title":"Clin Radiol"},{"key":"4045_CR3","doi-asserted-by":"publisher","first-page":"E805","DOI":"10.21037\/jtd.2017.07.109","volume":"9","author":"M Hashimoto","year":"2017","unstructured":"Hashimoto M, Tsukamoto Y, Matsuo S, Nakamichi T, Kondo N, Hasegawa S. Lung metastases in an atypical type A thymoma variant. J Thorac Dis. 2017;9:E805\u20137.","journal-title":"J Thorac Dis"},{"key":"4045_CR4","first-page":"101944","volume":"46","author":"M Hirai","year":"2023","unstructured":"Hirai M, Suzuki M, Imoto T, Shimizu R, Harada M, Hishima T, et al. Atypical type A thymoma component identified by pulmonary metastasectomy 11 years after surgery of type AB thymoma. Respir Med Case Rep. 2023;46:101944.","journal-title":"Respir Med Case Rep"},{"key":"4045_CR5","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s13256-015-0551-6","volume":"9","author":"PW Huang","year":"2015","unstructured":"Huang PW, Chang KM. Solitary metastasis to the breast after complete resection of encapsulated type AB thymoma: a case report. J Med Case Rep. 2015;9:63.","journal-title":"J Med Case Rep"},{"key":"4045_CR6","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.1111\/1759-7714.13975","volume":"12","author":"T Tatematsu","year":"2021","unstructured":"Tatematsu T, Okuda K, Endo K, Hattori H, Matsui T, Oda R, et al. Type A thymoma with simultaneous solitary intrapulmonary metastasis: A case report. Thorac Cancer. 2021;12:1923\u20136.","journal-title":"Thorac Cancer"},{"key":"4045_CR7","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1200\/JCO.1994.12.6.1164","volume":"12","author":"PJ Loehrer","year":"1994","unstructured":"Loehrer PJ, Sr, Kim K, Aisner SC, Livingston R, Einhorn LH, Johnson D, et al. Cisplatin plus doxorubicin plus cyclophosphamide in metastatic or recurrent thymoma: final results of an intergroup trial. The Eastern Cooperative Oncology Group, Southwest Oncology Group, and Southeastern Cancer Study Group. J Clin Oncol. 1994;12:1164\u20138.","journal-title":"J Clin Oncol"},{"key":"4045_CR8","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1093\/ejcts\/ezu210","volume":"47","author":"T Murakawa","year":"2015","unstructured":"Murakawa T, Karasaki T, Kitano K, Nagayama K, Nitadori J, Anraku M, et al. Invasive thymoma disseminated into the pleural cavity: mid-term results of surgical resection. Eur J Cardiothorac Surg. 2015;47:567\u201372.","journal-title":"Eur J Cardiothorac Surg"},{"issue":"10 Suppl 4","key":"4045_CR9","doi-asserted-by":"publisher","first-page":"S260","DOI":"10.1097\/JTO.0b013e3181f1f62d","volume":"5","author":"EA Engels","year":"2010","unstructured":"Engels EA. Epidemiology of thymoma and associated malignancies. J Thorac Oncol. 2010;5(10 Suppl 4):S260\u20135.","journal-title":"J Thorac Oncol"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-026-04045-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-026-04045-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-026-04045-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:35:37Z","timestamp":1780014937000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13019-026-04045-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4045"],"URL":"https:\/\/doi.org\/10.1186\/s13019-026-04045-5","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]},"assertion":[{"value":"8 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Obtained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"290"}}