Contribution of laparoscopic surgery to the diagnosis of ovarian metastasis from thymoma: A rare case and review of the literature.

Background: Thymoma is a rare mediastinal tumor that usually remains confined to the thoracic cavity. Extrathoracic metastasis is uncommon, and ovarian involvement is extremely rare. Only a few cases have been reported. Laparoscopic surgery provides a minimally invasive option for diagnosis and treatment in such unusual presentations. Case presentation: A 53-year-old woman with a history of thymoma treated with surgery, chemotherapy, and radiotherapy was found to have a mildly enlarged right ovary and a nodule in the pouch of Douglas five years after initial therapy. Because peritoneal dissemination of thymoma is rare, a primary ovarian tumor was suspected. Diagnostic laparoscopy was performed, resulting in bilateral salpingo-oophorectomy and resection of peritoneal nodules. Histopathology confirmed bilateral ovarian metastases and peritoneal dissemination from thymoma. The patient recovered uneventfully and resumed systemic chemotherapy. Conclusion: Ovarian metastasis from thymoma is extremely rare but should be considered in patients with a history of thymoma presenting with adnexal masses. This case underscores the diagnostic and therapeutic utility of laparoscopic surgery. Our findings add to the limited literature on extrathoracic spread of thymoma and highlight the role of minimally invasive techniques in such diagnostic challenges.