Background:For WHO type A thymoma,recurrence or metastases are rare and a few cases have been reported previously.Treatment of recurrence or metastases A thymoma are still undefined.Methods:We reported the treatment and prognosis in patients with WHO type A thymoma from June 2006 to March 2016 in Zhejiang Cancer Hospital.And we also reviewed literatures that reported recurrence and metastasis in WHO Type A thymoma.Results:Seven patients of type A thymoma were included in this study.According to the Masaoka–Koga system,stage I in five patients,stage III and IV in 2 patients at diagnosis.Five stage I patients received surgery.For clinical follow up in these 5 patients ranged from 54 months to 129 months and all were alive without recurrence.In addition,the stage III patient received postoperative radiotherapy and chemotherapy.After 35.5 months,the presence of metastases in left supraclavicular tissue and needle biopsy showing type A indicated disease progression.Then she received chemotherapy and supraclavicular tumor radiotherapy.The patient was alive with no evidence of progression disease.The stage IV patient received first line chemotherapy and efficacy evaluation was stable disease.After 45.7 months,the presence of tumors mass increased in anterior superior mediastinum and multiple nodules in both lungs.The lung tumor biopsy also showed type A thymoma.Then he received second line chemotherapy.The efficacy was SD.And he was alive without progression disease.Conclusions:Our retrospective study indicates that type A thymoma has potential in recur or have malignant feature.However its progresses may be more slowly than other types.It needs to under regular reexamination even after surgery and appropriate treatment methods.