# Synchronous Thymoma and Esophageal Cancer Treated With Minimally Invasive Unilateral Video-Assisted Thoracoscopic Surgery: A Case Report

## TL;DR

A 68-year-old man with two rare cancers was successfully treated with minimally invasive surgery, offering a new approach for similar cases.

## Contribution

A novel minimally invasive surgical strategy for synchronous thymoma and esophageal cancer is proposed.

## Key findings

- Minimally invasive surgery allowed concurrent resection of both tumors with no adverse events.
- Posterior mediastinal gastric conduit reconstruction reduced risks of tumor invasion and radiation exposure.
- A treatment strategy flow for adjacent multi-organ neoplasms was developed and validated.

## Abstract

The treatment of multi-organ synchronous neoplasms requires a customized strategy for each case. Here, we present our treatment strategy for synchronous double neoplasms involving thymoma and esophageal cancer, which is a rare occurrence in clinical practice. A 68-year-old man was diagnosed with thymoma and advanced esophageal cancer in the middle thoracic esophagus. Following neoadjuvant chemotherapy for esophageal cancer, a concurrent resection of both lesions was performed using minimally invasive unilateral video-assisted thoracoscopic surgery and laparoscopic surgery with gastric conduit reconstruction via the posterior mediastinal route. The patient was discharged on the 14th postoperative day without any adverse events. Minimally invasive, video-assisted unilateral simultaneous surgery for thymoma and esophageal cancer represents a viable therapeutic approach, offering both curative potential and decreased invasiveness. Furthermore, reconstructing the gastric conduit via the posterior mediastinal route was deemed appropriate, as it may help minimize the risk of invasion of the gastric conduit and radiation exposure in the event of thymoma disease progression. Additionally, we propose a treatment strategy flow for synchronous neoplasms located in adjacent multi-organs. This strategy can be applied to various tumor types and may benefit other complex cases.