A Case of Thymoma Masquerading as Hiatus Hernia, Pericardial Effusion: A Diagnostic Dilemma

Abstract

Thymoma is a rare neoplasm of the thymus gland, and as an adult, it accounts for 30% of anterior mediastinal tumors. The peak incidence is between 55 and 65 years old. Thymoma is a cancer that is extremely uncommon, accounting for just 0.2-1.5% of all malignancies, with an estimated incidence of between 0.13 and 0.32 per 100,000 people each year. We discuss a rare instance of a 58-year-old female patient who was admitted after complaining of multiple joint pain, gastroesophageal reflux disease (GERD), and generalized weakness. She was initially diagnosed with hiatus hernia and pericardial effusion based on imaging studies. However, her symptoms persisted despite treatment, and further evaluation revealed the presence of a thymoma. It was hard to make a diagnosis because the patient had a thymoma, a hiatus hernia, and pericardial effusion all at the same time. The initial diagnosis was complicated by the fact that the patient had unusual and refractory symptoms, which means they needed a thorough evaluation and follow-up. His case highlights the diagnostic complexity associated with thymoma, especially when coexisting with other conditions such as hiatus hernia and pericardial effusion. Despite its rarity, thymoma necessitates considerations in patients presenting with nonspecific symptoms, emphasizing the importance of thorough evaluation and follow-up. This underscores the need for a comprehensive diagnostic approach to ensure timely and accurate management, particularly in cases with an atypical and refractory presentation. In the described case, nurses' initial assessment skills are crucial for identifying the need for critical care intervention. Their role extends beyond the perioperative phase, encompassing patient education on procedures and potential outcomes.