Computed tomography scan of a 37-yr-old male who presented with dyspnoea and fatigue. Computed tomography scan of a 37-yr-old male who presented with dyspnoea and fatigue. Invasive tumour of the anterior mediastin was observed in the right hemithorax (arrow); percutaneous biopsy showed a type B3 thymoma. The patient received multimodal treatment with primary chemotherapy followed by surgical resection. Resection status was R1. Post-operative radiotherapy was delivered. Nicolas Girard Eur Respir Rev 2013;22:75-87 ©2013 by European Respiratory Society