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Mentions: A 55-year-old Japanese male was admitted to the Kitasato University Hospital for further examination and treatment for an abnormal shadow on the chest x-ray found at a regular health check-up. He had smoked 35 packs per year for 20 years. Chest x-ray films showed a solid mass with a clear border at the right hilum and a negative silhouette sign for the right first arch (Figure 1). Enhanced chest computed tomography (CT) revealed a solid mass 42 mm in diameter with a partially unclear margin with the normal thymic tissue in the anterior mediastinum (Figure 2). Magnetic resonance imaging (MRI) using intravenous contrast medium showed isointensity of the mass on both T1- and T2-weighted images (Figure 3, 4). Although chest CT and MRI revealed no invasion of the superior vena cava and the innominate vein, the tumor was highly suspected to have invaded the normal thymic tissue. Laboratory findings and results for tumor markers such as CEA (carcinoembryonic antigen), NSE (neuron specific enolase), and ProGRP (pro-gastrin releasing peptide) were all within normal ranges, preoperatively.
Thymic large cell neuroendocrine carcinoma: report of a resected case - a case report
Bottom Line: A 55-year-old male was admitted to our hospital for treatment of an anterior mediastinal tumor found at a regular health check-up.Final pathological diagnosis of the surgical specimen was thymic LCNEC.The patient underwent adjuvant chemotherapy with irinotecan and cisplatin in accordance with the diagnosis of a lung LCNEC, and is alive without recurrence or metastasis 16 months after surgery.
Affiliation: Department of Thoracic Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
Thymic large cell neuroendocrine carcinomas (LCNECs) are very rare. We here describe a case in which the tumor could be completely resected. A 55-year-old male was admitted to our hospital for treatment of an anterior mediastinal tumor found at a regular health check-up. The patient underwent an extended thymectomy of an invasive thymoma of Masaoka's stage II that had been suspected preoperatively. The tumor was located in the right lobe of the thymus and was completely resected. Final pathological diagnosis of the surgical specimen was thymic LCNEC. The patient underwent adjuvant chemotherapy with irinotecan and cisplatin in accordance with the diagnosis of a lung LCNEC, and is alive without recurrence or metastasis 16 months after surgery.
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