LAUSR

tapazole-treated hyperthyroidism and remote hystero-ovariectomy. Physical examination was unremarkable except for overt ankle edema. Blood pressure was 112/74 mmHg in the absence of antihypertensive medications. Laboratory analysis revealed renal failure (creatinine 327 μmol/L), hyponatremia (115 mmol/L) and hypokalemia (2.7 mmol/L) believed to be secondary to continuous diarrhoeic fluid loss. The patient was referred to our nephrology unit where biochemical analysis showed, in addition to renal failure, reduced total blood proteins (39.2 g/L) and hypoalbuminemia (18 g/L) with nephrotic-range proteinuria (from 6 g/24 h at admission up to 21 g/24 h). Serum creatinine progressively increased up to 485 μmol/L, despite adequate hydration and resolution of diarrhea. A routine chest X-ray incidentally revealed an anterosuperior mediastinic mass of 12 × 6 × 7 cm. The immunological and hematological diagnostic workup did not reveal abnormalities, and the patient was empirically started on prednisone 50 mg/day. The diagnostic work-up was completed with a CT of the chest showing a solid mass with axial diameters of 10 × 6.5 cm with regular profiles (Fig. 1). The analysis of the CT-guided biopsy of the mass allowed the diagnosis of type A thymoma. The patient was then referred to the thoracic surgery unit for the surgical removal of the tumor whose pathological analysis confirmed a radically resected type A thymoma (Masaoka IIb, pT2N0). In few days from the surgical intervention, renal function and proteinuria progressively improved to a complete normalization (Table 1). Due to the patient’s poor hemodynamic conditions and the rapid biochemical and clinical improvement, including renal function, after the ablation of the thymoma, renal biopsy, programmed for pathological correlation, was not performed and the patient was discharged in full nephrological and oncological remission Editor,