Case ReportMinimally invasive resection of synchronous triple primary tumors of the esophagus, lung, and thymus: A case report

•We firstly report a patient of synchronous esophagus and lung cancer with thymoma.•The video-assisted esophagectomy and VATS lobectomy and thymomectomy in a single operation are feasible and safe.•Our case illustrates a dilemma: what to do and what to expect when managing a patient with triple primary tumors.•Good clinical outcomes could be achieved with minimally invasive surgery.

IntroductionReports of synchronous multiple primary tumors are very rare. We report a case of synchronous esophagus and lung cancer combined with thymoma treated with a minimally invasive approach.Presentation of caseIn a 63-year-old patient, cT2 esophageal squamous cell carcinoma was found. Chest computed tomography revealed a lesion in the right upper lobe combined with an antero-superior mediastinal mass. She was treated with one-stage bilateral video-assisted thoracoscopic + laparoscopic esophagectomy with lymph node dissection and lobectomy with complete lymphadenectomy followed by thymomectomy and demonstrated a favorable response at early follow-up, without severe adverse surgical complications and evidence of local recurrence or distant metastasis. But the long-term follow-up is still needed for the evaluation of therapeutic effects of surgery.DiscussionIn the diagnostic procedure we excluded the probability of esophageal carcinoma metastasizing to the lung. Considering the patient's physical condition permit, we performed a minimally invasive surgery for three tumors. Besides, suitable operative incisions are important for the success of surgery.ConclusionTo our knowledge, this is the first case report in which simultaneous minimally invasive resection of esophagus and lung cancer combined with thymoma.