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A rare case of primary thymic adenocarcinoma mimicking small cell lung cancer.

Cho EN, Park HS, Kim TH, Byun MK, Kim HJ, Ahn CM, Chang YS - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: A 36-year-old male patient presented with hoarseness over the past 3 months.The patient received four cycles of systemic chemotherapy, consisting of etoposide and cisplatin, with concurrent radiotherapy (6,000 cGy/30 fractions) to the mediastinal lesion and the metastatic brain lesion (4,200 cGy/12 fractions).A follow-up chest CT scan and brain MRI showed a decrease in the size of the left upper mediastinal mass and brain lesion.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Primary thymic adenocarcinoma is a very rare malignancy of the anterior mediastinum with no standardized treatment. A 36-year-old male patient presented with hoarseness over the past 3 months. A chest computed tomography (CT) scan showed an infiltrative mass to the proximal vessels and aortic arch in left upper mediastinum (4.1×3.1×5.4 cm). Brain magnetic resonance imaging (MRI) showed focal lesions, suggesting metastasis in the left frontal lobe. A thoracoscopic biopsy of the mediastinal mass confirmed a primary thymic adenocarcinoma forming a glandular structure with atypia of tumor cells. The patient received four cycles of systemic chemotherapy, consisting of etoposide and cisplatin, with concurrent radiotherapy (6,000 cGy/30 fractions) to the mediastinal lesion and the metastatic brain lesion (4,200 cGy/12 fractions). A follow-up chest CT scan and brain MRI showed a decrease in the size of the left upper mediastinal mass and brain lesion. We report a rare case of the primary thymic adenocarcinoma with a literature review.

No MeSH data available.


Related in: MedlinePlus

Radiographic images after the concurrent chemoradiation therapy. The size of the tumor decreased to 2.85 cm in diameter on the chest CT scan taken at the 1-month follow-up visit (A) and successfully maintained the size at the 3-month follow-up visit, indicating stable disease (B). Brain MRI taken at the 1-month follow-up showed an almost resolved focal metastatic brain lesion on the left frontal lobe (C) and wellmaintained resolved lesion on the brain MRI taken at the 3-month follow-up visit (D).
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Figure 3: Radiographic images after the concurrent chemoradiation therapy. The size of the tumor decreased to 2.85 cm in diameter on the chest CT scan taken at the 1-month follow-up visit (A) and successfully maintained the size at the 3-month follow-up visit, indicating stable disease (B). Brain MRI taken at the 1-month follow-up showed an almost resolved focal metastatic brain lesion on the left frontal lobe (C) and wellmaintained resolved lesion on the brain MRI taken at the 3-month follow-up visit (D).

Mentions: Chest CT scan performed at a 1-month follow-up visit (Figure 3A) revealed decreased mass size (4.1 cm to 2.8 cm in diameter) and 3-month follow-up chest CT (Figure 3B) presented stable disease status described as no interval change of residual encasing solid mass lesion at the left superior mediastinum near the proximal neck vessel and aortic arch. Brain MRI performed at a 1-month follow-up visit (Figure 3C) and 3-month follow-up visit (Figure 3D) presented decreased focal lesion on left frontal lobe area. PET-CT taken at 1-month follow up visit showed disappeared hypermetabolic mass lesion just above the aortic arch, nearly disappeared hypermetabolic nodes in left supraclavicular region and markedly decreased fluoro-2-deoxyglucose uptake in the shrunken lesion of left paravertebral region, second thoracic spine level which are considered favorable response to the treatment. Regular chest CT follow-up in 3 months is planned.


A rare case of primary thymic adenocarcinoma mimicking small cell lung cancer.

Cho EN, Park HS, Kim TH, Byun MK, Kim HJ, Ahn CM, Chang YS - Tuberc Respir Dis (Seoul) (2015)

Radiographic images after the concurrent chemoradiation therapy. The size of the tumor decreased to 2.85 cm in diameter on the chest CT scan taken at the 1-month follow-up visit (A) and successfully maintained the size at the 3-month follow-up visit, indicating stable disease (B). Brain MRI taken at the 1-month follow-up showed an almost resolved focal metastatic brain lesion on the left frontal lobe (C) and wellmaintained resolved lesion on the brain MRI taken at the 3-month follow-up visit (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388894&req=5

Figure 3: Radiographic images after the concurrent chemoradiation therapy. The size of the tumor decreased to 2.85 cm in diameter on the chest CT scan taken at the 1-month follow-up visit (A) and successfully maintained the size at the 3-month follow-up visit, indicating stable disease (B). Brain MRI taken at the 1-month follow-up showed an almost resolved focal metastatic brain lesion on the left frontal lobe (C) and wellmaintained resolved lesion on the brain MRI taken at the 3-month follow-up visit (D).
Mentions: Chest CT scan performed at a 1-month follow-up visit (Figure 3A) revealed decreased mass size (4.1 cm to 2.8 cm in diameter) and 3-month follow-up chest CT (Figure 3B) presented stable disease status described as no interval change of residual encasing solid mass lesion at the left superior mediastinum near the proximal neck vessel and aortic arch. Brain MRI performed at a 1-month follow-up visit (Figure 3C) and 3-month follow-up visit (Figure 3D) presented decreased focal lesion on left frontal lobe area. PET-CT taken at 1-month follow up visit showed disappeared hypermetabolic mass lesion just above the aortic arch, nearly disappeared hypermetabolic nodes in left supraclavicular region and markedly decreased fluoro-2-deoxyglucose uptake in the shrunken lesion of left paravertebral region, second thoracic spine level which are considered favorable response to the treatment. Regular chest CT follow-up in 3 months is planned.

Bottom Line: A 36-year-old male patient presented with hoarseness over the past 3 months.The patient received four cycles of systemic chemotherapy, consisting of etoposide and cisplatin, with concurrent radiotherapy (6,000 cGy/30 fractions) to the mediastinal lesion and the metastatic brain lesion (4,200 cGy/12 fractions).A follow-up chest CT scan and brain MRI showed a decrease in the size of the left upper mediastinal mass and brain lesion.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Primary thymic adenocarcinoma is a very rare malignancy of the anterior mediastinum with no standardized treatment. A 36-year-old male patient presented with hoarseness over the past 3 months. A chest computed tomography (CT) scan showed an infiltrative mass to the proximal vessels and aortic arch in left upper mediastinum (4.1×3.1×5.4 cm). Brain magnetic resonance imaging (MRI) showed focal lesions, suggesting metastasis in the left frontal lobe. A thoracoscopic biopsy of the mediastinal mass confirmed a primary thymic adenocarcinoma forming a glandular structure with atypia of tumor cells. The patient received four cycles of systemic chemotherapy, consisting of etoposide and cisplatin, with concurrent radiotherapy (6,000 cGy/30 fractions) to the mediastinal lesion and the metastatic brain lesion (4,200 cGy/12 fractions). A follow-up chest CT scan and brain MRI showed a decrease in the size of the left upper mediastinal mass and brain lesion. We report a rare case of the primary thymic adenocarcinoma with a literature review.

No MeSH data available.


Related in: MedlinePlus