The International Thymic Malignancy Interest Group (ITMIG) is an academic society that has periodic virtual tumor board meetings to discuss challenging cases. The tumor board consists of an international panel of experts with significant interest and experience in thymic malignancies, with at least one representative from the following specialties; thoracic surgery, medical oncology, radiation oncology, diagnostic radiology, and thoracic pathology. Any clinician anywhere in the world who seeks assistance from the panel is encouraged to participant by submitting a case (including history, clinical questions, and radiographic and histologic images). Following the case discussion, the tumor board summarizes its conclusions in writing for the treating clinician to help guide them in their treatment plan. We present a case discussed at the virtual tumor board meeting conducted in April 2019.