Thymomas are uncommon neoplasms that account for 50% of all masses in the anterior mediastinum. Medial sternotomy is the typical approach for resection. We report a case of an ectopic thymoma within the right pleural cavity in a 76-year old Caucasian women. This patient was diagnosed on preoperative assessment with a large nodal lesion, measuring 12.5 × 9 × 11 cm. Extensive imaging and histology hinted the diagnosis of an ectopic thymoma type B1 according to the World Health Organisation (WHO) classification. Due to the rare location of this tumor, we decided to use a right lateral thoracotomy instead of the more commonly used medial sternotomy. Complete resection of the tumor was performed with relative ease and histopathology verified the diagnosis of a thymoma type B1. No continuity towards the superior anterior mediastinum was documented and the thymoma was considered 'ectopic'. To our knowledge ectopic thymomas are very rare, and few reports have been made about removing thymic tumors by means of a lateral thoracotomy.
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