Background: Thymolipoma is a rare benign anterior mediastinal tumor composed of thymic and adipose tissues. Early diagnosis and accurate surgical management are crucial to prevent misdiagnosis and optimize patient outcomes.

Methods: A 17-year-old male with no significant medical history presented to our thoracic surgery department with exertional dyspnea and a sensation of chest tightness. Given the worsening symptoms, a chest computed tomography (CT) scan was performed, revealing a well-circumscribed anterior mediastinal mass in the right paracardiac region, predominantly composed of fatty tissue. The patient underwent right thoracoscopic surgery, during which the tumor was successfully resected. The postoperative course was uneventful. Histopathological examination confirmed the diagnosis of a thymolipoma.

Conclusions: Thymolipomas are rare benign tumors composed of mature adipose tissue and thymic tissue, typically located in the anterior mediastinum. They account for less than 9 % of all thymic tumors and are often discovered incidentally. Patients with thymolipomas may present with nonspecific symptoms, such as dyspnea, chest pain, or recurrent respiratory infections, depending on the size and compressive effects of the tumor. Imaging plays a crucial role in identifying thymolipomas, with CT scan often showing a well-encapsulated mass with fat and soft tissue components. Complete surgical resection remains the cornerstone of treatment, ensuring both accurate diagnosis and symptomatic relief. Conclusions: This case underlines the exceptional presentation of a thymolipoma, emphasizing its rarity and the critical role of surgical management in achieving optimal outcomes. Early recognition and intervention are crucial, especially for large or symptomatic lesions.