What is the most likely diagnosis? 
              
                - 40 year-old with weakness
 
              
                
                Frontal and lateral radiographs of chest
              
                - Tuberculosis
 
                - Dissecting Aneurysm
 
                - Thymoma
 
                - Substernal Thyroid
 
                - Bronchogenic Carcinoma
 
              
              Additional Images - Enhanced Axial CT of Chest
              
             
            
               
              Additional Images
               
              
                      
              Enhanced Axial CT of Chest
              
             
            
              
                  Answer:
               
              
                3. Thymoma
                 
              
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              Thymoma
                
              
              General Considerations
              
                - Most  common anterior mediastinal neoplasm
 
                - Mean  age of presentation is 52, older than teratomas
 
                - Most are solid lymphoepithelial tumors  of the thymus, some are cystic 
 
                - About  1/3 are malignant
 
                - Rare  in children — most common around 5th or 6th decade