Multifocal Thymic Tumors with Systemic Hypercoagulability: A Rare Autopsy Case Report

Thymic tumors (TM) are rare epithelial neoplasms that are typically associated with autoimmune disorders, but their potential role in systemic hypercoagulability remains largely unexplored. We report an unusual autopsy case of a deceased male in his 60s, in which seven distinct TM were identified throughout his mediastinum. Histologic analysis confirmed WHO subtype B2 thymomas, characterized by lobulated architecture, abundant lymphocytes, and focal necrosis. Strikingly, multiple ante-mortem thrombi were found in the coronary, pulmonary, mesenteric, and carotid arteries, raising concern for a paraneoplastic hypercoagulable state akin to Trousseau’s syndrome. While thrombotic complications are well-recognized in other malignancies, they are exceedingly rare in thymomas, particularly in cases with multifocal involvement and widespread arterial thrombosis. This case highlights the need for increased clinical awareness of potential coagulation abnormalities in thymic neoplasms and supports further investigation into their pathophysiological mechanisms.