Summary
Among 54 mediastinal tumours we examined in the past 20 years, there were 5 cases of primary thymic carcinomas, each with widespread metastases. Histological features in three cases were consistent with lymphoepithelioma-like carcinoma. One case showed an epidermoid pattern with keratotic pearls resembling Hassall bodies. One undifferentiated carcinoma developed from a cortical thymoma. Epstein-Barr virus could not be detected in tumour tissue with in situ hybridization. A review of the literature revealed only 94 well-documented cases of thymic carcinoma. Both thymic carcinomas and thymomas are neoplasms of the thymic epithelial cells, but thymic carcinomas are obviously histologically malignant and usually not associated with any parathymic syndromes. Epidermoid and lymphoepithelioma-like carcinomas are described along with special forms, such as small- and clear-cell carcinomas, basaloid, sarcomatoid, mucoepidermoid, and adenocystic carcinoma. Compared to the other forms, lymphoepithelioma-like carcinoma has a poor prognosis in regard to metastases and rate of survival. Some thymic carcinomas may develop from pre-existing thymomas.
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Abbreviations
- EBV:
-
Epstein-Barr virus
References
Adams JE (1963) Leucemogenic thymoma. Report of a unique case. Am J Clin Pathol 40:173–182
Alguacil-Garcia A, Halliday W (1987) Thymic carcinoma with focal neuroblastoma differentiation. Am J Surg Pathol 11:474–479
Andritsakis GD, Sommers SC (1959) Criteria of thymic cancer and clinical correlations of thymic tumors. J Thorac/Cardiovasc/ Surg 37:273–290
Arriagada R, Bretel JJ, Caillaud JM, Garreta L, Guerin RA, Laugier A, Le Chevalier T, Schlienger M (1984) Invasive carcinoma of the thymus. A multicenter retrospective review of 56 cases. Eur J Cancer Clin Oncol 20:69–74
Batata MA, Martini M, Huevos AG, Aguilar RI, Beattie EJ (1974) Thymomas: clinicopathologic features, therapy, and prognosis. Cancer 34:389–396
Baud M, Stamencovic I, Kapanci Y (1981) Malignant thymomas: clinicopathologic study of 13 cases. In: Fenoglio CM, Wolf M (eds) Progress in surgical pathology, vol III. Masson, New York, pp 129–146
Bedford GV (1930) A case of carcinoma of the thymus with extensive metastases in a new born child. Can Med Assoc J 23:197–202
Brannan D (1926) Carcinoma of the thymus and occlusion of the superior vena cava. Arch Pathol Lab Med 1:584–596
Chen KTK (1984) Squamous carcinoma of the thymus. J Surg Oncol 25:61–63
Danisch F, Nedelmann E (1924) Bösartiges Thymom bei einem 3 1/2jährigen Kind mit eigenartiger Metastasierung ins Zentralnervensystem. Virchows Arch 268:492–514
Dimery IW, Lee JS, Blick M, Pearson G, Spitzer G, Hong WK (1988) Association of the Epstein-Barr virus with lymphoepithelioma of the thymus. Cancer 61:2475–2480
Dugiud JB, Kennedy AM (1930) Oat-cell tumours of mediastinal glands. J Pathol Bacteriol 33:93–99
Frank E (1945) Thymuskarzinom mit Cushingschem Syndrom (Der thymogene Morbus Cushing). Schweiz Med Wochenschr 75:152–154
Frank HA, Reiner L, Fleischner FG (1956) Co-occurence of large leiomyoma of the esophagus and squamous-cell carcinoma of the thymus. Report of a case, with roentgenologic, pathologic and clinical discussion. New Engl J Med 255:159–164
Friedman NB (1967) Tumors of the thymus. J Thorac Cardiovasc Surg 53:163–182
Goldman KP (1974) Malignant thymoma in pregnancy. Br J Dis Chest 68:279–283
Gray GF, Gutowski WTh (1979) Thymoma. A clinicopathologic study of 54 cases. Am J Surg Pathol 3:235–249
Guillan RA, Zelman S, Smalley RL, Iglesias PA (1971) Malignant thymoma associated with myasthenia gravis, and evidence of extrathoracic metastases. An analysis of published cases and report of a case. Cancer 27:823–830
Hartmann C-A, Hanke S (1984) Ungewöhnliche Pleurabeteiligung eines metastasierenden Thymoms. Pathologe 5:169–172
Hartmann C-A, Minck C, Roth Chr, Weise I (1988) Thymuskarzinom. Bericht über 4 Fälle. Z Herz Thorax Gefäßchir 2:191–197
Hartmann C-A, Minck C, Dienemann D, Niedobitek G, Stein H (1989) Thymuskarzinoid und mediastinales Paragangliom. Differentialdiagnose und immunhistologische Untersuchung. Pathologe 10:323–331
Herczeg E, Kahn LB (1986) Primary thymic carcinoma. An unusual case originating in a lymphocytic rich thymoma. Virchows Arch A 409:163–169
Hofmann W, Möller P, Manke H-G, Otto HF (1985) Thymoma. A clinicopathologic study of 98 cases with special references to three unusual cases. Pathol Res Pract 179:337–353
Jacobson VC (1923) Primary carcinoma of the thymus. Arch Int Med 31:847–856
Jain U, Frable WJ (1974) Thymoma. Analysis of benign and malignant criteria. J Cardiovasc Surg 67:310–321
Kawase I, Saijo N, Suzuki A, Niitani H, Kameya T, Shimasotu Y (1975) A case of thymoma with extrathoracic metastases. Jpn J Clin Oncol 5:131–144
Ketelbant-Balasse P, Paulet PH, Daled HJ, Cauchie Ch (1972) Thymome malin à composante épithéliale avec métastases généralisées. Ann Anat Pathol 17:211–219
Kirchner Th, Hoppe F, Marx A, Papadopulos, Müller-Hermelink HK (1988) Histogenetische und funktionelle Merkmale der Epitheldifferenzierung in Thymomen und Thymuskarzinomen. Verh Dtsch Ges Pathol 72:349–353
Kleinert R, Walter GF, Kleinert G (1985) Carcinomatous meningeosis as exclusive metastasizing pattern in a malignant thymoma. Acta Neuropathol 67:329–331
Kodama T, Watanabe S, Sato Y, Shimasotu Y, Miyazawa N (1986) An immunohistochemical study of epithelial tumors. I. Epithelial component. Am J Surg Pathol 10:26–33
Kracht J, Hantschmann N (1961) Tumorsyntropien des Cushing-Syndroms. Acta Endocrinol 38:490–541
Largiadèr H (1923) Zur Kenntnis der bösartigen Thymusgeschwülste, insbesondere des Thymuskarzinoms. Frankf Z Pathol 29:228–248
Lemann II, Smith J (1926) Primary carcinoma of the thymus. Arch Int Med 38:807–815
Levine GD, Rosai J (1978) Thymic hyperplasia and neoplasia: a review of current concepts. Hum Pathol 9:495–515
Lewis JE, Wick MR, Scheithauer BW, Bernatz PhE, Taylor WF (1987) Thymoma. A clinicopathologic review. Cancer 60:2227–2743
Leyton O, Turnbull HM, Bratton AB (1931) Primary cancer of the thymus with pluriglandular disturbance. J Pathol Bacteriol 34:635–660
Leyvraz S, Henle W, Chahinian APh, Perlman K, Klein G, Gordon RE, Rosenblum M, Holland JF (1985) Association of Epstein-Barr virus with thymic carcinoma. N Engl J Med 312:1296–1299
Marchevsky AM, Kaneko M (1984) Surgical pathology of the mediastinum. Raven Press, New York, pp 90–96
Marino M, Müller-Hermelink HK (1985) Thymoma and thymic carcinoma. Relation of thymoma epithelial cells to the cortical and medullary differentiation of the thymus. Virchows Arch [A] 407:119–149
Masaoka A, Monden Y, Nakakara K, Tanioka T (1981) Follow-up study of thymomas with special reference to their clinical stages. Cancer 48:2485–2492
Massart JJ, Bishop WA (1968) Thymoma occuring during pregnancy. A case report. Obstet Gynecol 32:490–493
Micheau Chr (1986) What's new in histological classification and recognition of naso-pharyngeal carcinoma (N.P.C.)? Pathol Res Pract 181:249–253
Minkowitz St, Solomon L, Nicastri AD (1968) Cytologically malignant thymoma with distant metastases. Cancer 21:426–433
Morinaga Sh, Sato Y, Shimasotu Y, Sinkai T, Tsuchiya R (1987) Multiple thymic squamous cell carcinomas associated with mixed type thymoma. Am J Surg Pathol 11:982–988
Möller P, Hofmann WJ, Mielke B, Otto HF (1989) Das primäre mediastinale, hellzellige B-Zell Lymphom ist ein epithelassoziiertes Thymuslymphom. Pathologe 10:234–239
Müller-Hermelink HK, Marino M, Palestro G (1986) Pathology of thymic epithelial tumors. Curr Top Pathol 75:207–268
Nagaoka Y (1973) Histological and clinical study on thymoma. Nihon Kyobu Geka Gakkai Zasski 21:768–793
Nickels J, Franssilla K (1976) Thymoma metastasizing to extrathoracic sides. Acta Pathol Microbiol Scand [A] 84:331–334
Niedobitek G, Hamilton-Dutoit S, Herbst H, Finn T, Vetner M, Pallesen G, Stein H (1989) Identification of Epstein-Barr virus infected cells in tonsils of acute infection mononucleosis by in situ hybridization. Hum Pathol 20:796–799
O'Gara RW, Horn RC, Enterline HT (1958) Tumors of the anterior mediastinum. Cancer 11:562–590
Otto HF (1984) Pathologie des Thymus. In: Doerr W, Seifert G (eds) Spezielle pathologische Anatomie, Band 17. Springer, Berlin Heidelberg New York Tokyo
Rosai J, Levine GD (1976) Tumors of the thymus. In: Atlas of tumor pathology, 2nd series, fascicle 13. AFIP, Washington DC
Rosai J, Levine GD, Weber WR, Higa E (1976) Carcinoid tumors and oat cell carcinomas of the thymus. Pathol Annu 11:201–226
Sabiston DC, Scott HW (1952) Primary neoplasms and cysts of the mediastinum. Ann Surg 136:777–797
Salyer WR, Eggleston JC (1976) Thymoma. A clinical and pathologic study of 65 cases. Cancer 37:229–249
Schmidtmann M (1919) Zur Kenntnis seltener Krebsformen. Virchows Arch 226:100–118
Sellors TH, Thackray AC, Thompson AD (1967) Tumours of the thymus. A review of 88 operation cases. Thorax 22:193–220
Shimasotu Y, Kameya T, Nagai K, Suemazu K (1977) Squamous cell carcinoma of the thymus. An analysis of eight cases. Am J Surg Pathol 1:109–121
Snover DC, Levine GD, Rosai J (1982) Thymic carcinoma. Five distinctive histological variants. Am J Surg Pathol 6:451–470
Soutter L, Sommers Sh, Relman AS, Emerson ChP (1957) Problems in the surgical management of thymic tumors. Ann Surg 146:424–438
Swinborne-Sheldrake K, Gray GF, Glick AD (1986) Thymic epithelial neoplasms. South Med J 78:790–800
Symmers D, Vance BM (1921) Epitheliomata of thymic origin. Arch Int Med 28:243–251
Tanaka M, Shimokawa R, Matsurara O, Kamemiya R, Kasuga T, Hatakeyama SH (1982) Mucoepidermoid carcinoma of the thymic region. Acta Pathol Jpn 32:703–712
Verley JM, Hollmann KH (1985) Thymoma. A comparative study of clinical stages, histology features, and survival in 200 cases. Cancer 55:1074–1086
Watson RR, Weisel W, O'Connor ThM (1968) Thymic neoplasm. A surgical enigma. Arch Surg 97:230–238
Wick MR, Rosai J (1988) Neuroendocrine neoplasms of the thymus. Pathol Res Pract 183:188–199
Wick MR, Weiland LH, Scheithauer BW, Bernatz PhE (1982) Primary thymic carcinomas. Am J Surg Pathol 6:613–630
Zajewloschin MN (1910) Carcinoma der Thymus. Virchows Arch 254:63–69
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Hartmann, C.A., Roth, C., Minck, C. et al. Thymic carcinoma. J Cancer Res Clin Oncol 116, 69–82 (1990). https://doi.org/10.1007/BF01612643
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DOI: https://doi.org/10.1007/BF01612643