Atypical behaviour of thymic carcinoma

Main Article Content

Alberto Oldani
Sergio Gentilli
Manuela Monni
Paolo Bellora
Glenda Grossi
Caterina Casadio
Marcello Garavoglia

Abstract

AIM: To describe the case of a thymic carcinoma with atypical clinical behavior that has arisen with a voluminous metastasis at the right hemidiaphragm while the primitive thymic neoplasm was initially occult.


CASE REPORT: A 42 years female patient came to clinical observation for a voluminous thoraco-abdominal mass located  in right side, infiltrating the diaphragm. The patient was submitted to surgical excision of the mass; definitive histological  examination: non-keratinizing spinocellular carcinoma suggestive for neoplasia on ectopic thymic tissue or metastasis  from carcinoma of the thymus. Three 3 months after surgery MR and CT-scan restaging identified the presence of anterior mediastinal mass of about 3 cm of diameter, compatible with thymical origin; thymectomy was performed (histology:  Lymphoepithelial thymoma). Eight months after the first surgical procedure a restaging by CT, MR and PET CT showed the presence of disease recurrence at the right diaphragmatic level. The patient underwent surgical exploration, with right thoracotomic approach: a metastasis in the hepatic segment VII was found and radically removed. Six months after liver metastasis resection, CT scan showed disease progression in mediastinum, with involvement of pericardium and aorta; the patient died for disease recurrence five months later, 22 months after the first surgical procedure.


CONCLUSION: Thymic neoplasms are the most common tumors of the mediastinum; a small percentage of these tumors are however extremely aggressive carcinomas. Rare but not exceptional findings are also cancers arising from ectopic thymic tissue.

Article Details

How to Cite
Oldani, Alberto, et al. “Atypical Behaviour of Thymic Carcinoma”. Annali Italiani Di Chirurgia, vol. 3, no. November, Nov. 2014, pp. 1-5, https://annaliitalianidichirurgia.it/index.php/aic/article/view/1242.
Section
Case Report