General Thoracic and Cardiovascular Surgery

, Volume 59, Issue 1, pp 68–72 | Cite as

Simultaneous double thymic carcinoids: a rare initial manifestation of multiple endocrine neoplasia type 1

  • Ryutaro Kikuchi
  • Nobuya Mino
  • Taku Okamoto
  • Tadashi Matsukura
  • Takashi Hirai
Case Report


A 53-year-old man was referred to our hospital for treatment of two anterior mediastinal tumors. The anterior mediastinal tumors were resected by thymectomy under the probable diagnosis of double thymomas. The final pathological diagnosis was multiple thymic carcinoids. Although 20%–25% of patients with thymic carcinoid have a family history of multiple endocrine neoplasia type 1 (MEN-1), radiographic screening just after the operation did not detect any endocrine tumors. However, the patient had a urinary calculus 4 months 7 months after the operation. Endocrinological examination then revealed mild hypercalcemia, hypophosphatemia, hyperinsulinemia, and hyperprolactinemia. Radiologically, a parathyroid tumor and a pancreatic tumor were found. The patient was referred to a university hospital and a mutation of MEN-1 gene was detected. The diagnosis of MEN-1 was confirmed about 1 year after the operation.

Key words

Thymic carcinoid Well-differentiated neuroendocrine carcinoma of the thymus Multiple endocrine neoplasia type 1 (MEN-1) Surgical resection 


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  1. 1.
    Marx A, Shimosato Y, Kuo TT, Chan JKC, Travis WD, Wick MR. Thymic neuroendocrine tumours. In: Travis WD, Brambillia E, Müller-Hermelink HK, Haris CC, editors. Tumors of the lung, pleura, thymus and heart. Lyon: IARC Press; 2004. p. 188–195.Google Scholar
  2. 2.
    Tiffet O, Nicholson AG, Ladas G, Sheppard MN, Goldstraw P. A clinicopathologic study of 12 neuroendocrine tumors arising in the thymus. Chest 2003;124:141–146.CrossRefPubMedGoogle Scholar
  3. 3.
    Moran CA, Suster S. Neuroendocrine carcinomas (carcinoid tumor) of the thymus: a clinicopathologic analysis of 80 cases. Am J Clin Pathol 2000;114:100–110.CrossRefPubMedGoogle Scholar
  4. 4.
    Teh BT, Zedenius J, Kytola S, Skogseid B, Trotter J, Choplin H, et al. Thymic carcinoids in multiple endocrine neoplasia type 1. Ann Surg 1998;228:99–105.CrossRefPubMedGoogle Scholar
  5. 5.
    Gibril F, Chen YJ, Schrump DS, Vortmeyer A, Zhuang Z, Lubensky IA, et al. Prospective study of thymic carcinoids in patients with multiple endocrine neoplasia type 1. J Clin Endocrinol Metab 2003;88:1066–1081.CrossRefPubMedGoogle Scholar
  6. 6.
    Rosai J, Higa E. Mediastinal endocrine neoplasm, of probable thymic origin, related to carcinoid tumor: clinicopathologic study of 8 cases. Cancer 1972;29:1061–1074.CrossRefPubMedGoogle Scholar
  7. 7.
    Wick MR, Scheithauer BW. Thymic carcinoid: a histologic, immunohistochemical, and ultrastructural study of 12 cases. Cancer 1984;53:475–484.CrossRefPubMedGoogle Scholar
  8. 8.
    Oberg K, Jelic S. Neuroendocrine bronchial and thymic tumors: ESMO clinical recommendation for diagnosis, treatment and follow-up. Ann Oncol 2008;19(suppl 2):ii102–iii103.CrossRefPubMedGoogle Scholar
  9. 9.
    Fukai I, Masaoka A, Fujii Y, Yamakawa Y, Yokoyama T, Murase T, et al. Thymic neuroendocrine tumor (thymic carcinoid): a clinicopathologic study in 15 patients. Ann Thorac Surg 1999;67:208–211.CrossRefPubMedGoogle Scholar
  10. 10.
    Soga J, Yakuwa Y, Osaka M. Evaluation of 342 cases of mediastinal/thymic carcinoids collected from literature: a comparative study between typical carcinoids and atypical varieties. Ann Thorac Cardiovasc Surg 1999;5:285–292.PubMedGoogle Scholar
  11. 11.
    Kondo K, Monden Y. Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg 2003;76:878–884; discussion 84–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Ferolla P, Falchetti A, Filosso P, Tomassetti P, Tamburrano G, Avenia N, et al. Thymic neuroendocrine carcinoma (carcinoid) in multiple endocrine neoplasia type 1 syndrome: the Italian series. J Clin Endocrinol Metab 2005;90:2603–2609.CrossRefPubMedGoogle Scholar
  13. 13.
    Wilkinson S, Teh BT, Davey KR, McArdle JP, Young M, Shepherd JJ. Cause of death in multiple endocrine neoplasia type 1. Arch Surg 1993;128:683–690.PubMedGoogle Scholar
  14. 14.
    Srirajaskanthan R, Toubanakis C, Dusmet M, Caplin ME. A review of thymic tumours. Lung Cancer 2008;60:4–13.CrossRefPubMedGoogle Scholar
  15. 15.
    Kaltsas GA, Papadogias D, Makras P, Grossman AB. Treatment of advanced neuroendocrine tumours with radiolabelled somatostatin analogues. Endocr Relat Cancer 2005;12:683–699.CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2011

Authors and Affiliations

  • Ryutaro Kikuchi
    • 1
  • Nobuya Mino
    • 1
  • Taku Okamoto
    • 1
  • Tadashi Matsukura
    • 1
  • Takashi Hirai
    • 1
  1. 1.Division of Thoracic SurgeryFukui Red Cross HospitalFukuiJapan

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