Lipofibroadenoma of the Thymus: A Case Report With Literature Review and Differential Diagnostic Considerations

Thymic lipofibroadenoma is a rare lesion composed of mature adipose tissue, fibrous stroma, and thymic epithelial elements.We describe a 51-year-old woman with recurrent syncope and a large anterior mediastinal mass compressing adjacent cardiac structures.Complete excision yielded an encapsulated, multilobulated mass measuring 14 × 4 × 2 cm.Histology showed bland epithelial strands and cords within dense hyalinized stroma admixed with mature fat and Hassall corpuscles.Epithelial cells expressed cytokeratins AE1/AE3 and 19, supporting the diagnosis of lipofibroadenoma.At six months, the patient was asymptomatic without imaging evidence of recurrence.A narrative review of 18 previously published cases addresses the clinicopathologic spectrum and differential diagnosis, particularly the overlap with thymolipoma and thymofibrolipoma.Reported outcomes generally favor benign behavior, although limited and uneven follow-up prevents firm conclusions about long-term recurrence risk.