This is a 67-years old lady who was operated for a sarcomatoid thymic carcinoma. The repeat PET/CT shows recurrence of disease, with spread to the lungs, pleura and the liver.
A biopsy was needed to reconfirm recurrence. In her case, an oblique left para-sternal approach using an 18G coaxial biopsy gun allowed a safe biopsy, with the needle tip directed away from the vessels. She had recurrence of disease.