Abstract
Primary thymic adenocarcinoma is an extremely rare tumor. This report describes a case of thymic adenocarcinoma with a peculiar pathological feature and clinical course. A 54-year-old man complained of cough, dyspnea, and chest pain. Computed tomography scans revealed an anterior mediastinal mass with intracaval growth into the superior vena cava. No definitive diagnosis could be made after several examinations and palliative radiotherapy was performed. He passed away 56 days after the appearance of the initial symptoms. An autopsy revealed that the mediastinal tumor obstructed not only the superior vena cava but also the pulmonary arteries. The histological findings revealed the tumor to be an adenocarcinoma with sarcomatous features. The tumor was immunohistochemically positive for CD5 and negative for thyroid transcription factor-1. These results suggested the tumor to be a thymic adenocarcinoma with sarcomatoid features; furthermore, the tumor invaded the great vessels, thus resulting in a poor prognosis.
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Ritter JH, Wick MR. Primary carcinomas of the thymus gland. Semin Diagn Pathol 1999;16:18–31.
Dorfman DM, Shahsafaei A, Chan JK. Thymic carcinomas, but not thymomas and carcinomas of other sites, show CD5 immunoreactivity. The American journal of surgical pathology 1997;21:936–940.
Chang YL, Lee YC, Liao WY, Wu CT. The utility and limitation of thyroid transcription factor-1 protein in primary and metastatic pulmonary neoplasms. Lung Cancer 2004;44:149–157.
Tateyama H, Eimoto T, Tada T, Hattori H, Murase T, Takino H. Immunoreactivity of a new CD5 antibody with normal epithelium and malignant tumors including thymic carcinoma. Am J Clin Pathol 1999;111:235–240.
Mirzoyan M, Muslimani A, Setrakian S, Swedeh M, Daw HA. Primary pleuropulmonary synovial sarcoma. Clin Lung Cancer 2008;9:257–261.
Alifano M, Parri SN, Arab WA, Bonfanti B, Lacava N, Porrello C, et al. Limited upper sternotomy in general thoracic surgery. Surg Today 2008;38:300–304.
Eng TY, Fuller CD, Jagirdar J, Bains Y, Thomas CR Jr. Thymic carcinoma: state of the art review. Int J Radiat Oncol Biol Phys 2004;59:654–664.
Blumberg D, Burt ME, Bains MS, Downey RJ, Martini N, Rusch V, et al. Thymic carcinoma: current staging does not predict prognosis. J Thorac Cardiovasc Surg 1999;117:628–630.
Yamazaki K, Takeo S, Takeshita M, Sugimachi K. Thymic carcinoma presenting as an intraluminal growth into the great vessels and the cardiac cavity. Ann Thorac Cardiovasc Surg 2002;8:163–166.
Ito H, Obara T, Sasano S, Onuki T, Nitta S. Eight cases of thymic carcinoma (in Japanese). Nippon Kyobu Geka Gakkai Zasshi 1994;42:2060–2067.
Moriyama S, Shimizu N, Kurita A, Teramoto S, Taguchi K. A case of adenocarcinoma of the thymus (in Japanese). Nippon Kyobu Geka Gakkai Zasshi 1989;37:717–722.
Babu MK, Nirmala V. Thymic carcinoma with glandular differentiation arising in a congenital thymic cyst. J Surg Oncol 1994;57:277–279.
Makino Y, Asada M, Suzuki T, Hashimoto M. A case of adenocarcinoma of the thymus (in Japanese). Jpn J Thorac Cardiovasc Surg 1998;46:1168–1171.
Matsuno Y, Morozumi N, Hirohashi S, Shimosato Y, Rosai J. Papillary carcinoma of the thymus: report of four cases of a new microscopic type of thymic carcinoma. Am J Surg Pathol 1998;22:873–880.
Shimono M, Hiraki A, Ueoka H, Tanimoto Y, Aoe M, Sakae K, et al. Successful treatment with concurrent chemoradiotherapy followed by surgery for a patient with thymic adenocarcinoma. Anticancer Res 2001;21:2519–2522.
Choi WW, Lui YH, Lau WH, Crowley P, Khan A, Chan JK. Adenocarcinoma of the thymus: report of two cases, including a previously undescribed mucinous subtype. Am J Surg Pathol 2003;27:124–130.
Zaitlin N, Rozenman J, Yellin A. Papillary adenocarcinoma in a thymic cyst: a pitfall of thoracoscopic excision. Ann Thorac Surg 2003;76:1279–1281.
Seki Y, Imaizumi M, Shigemitsu K, Yoshioka H, Ueda Y. Mucinous adenocarcinoma of the anterior mediastinum (in Japanese). Kyobu geka 2004;57:413–436.
Takahashi F, Tsuta K, Matsuno Y, Takahashi K, Toba M, Sato K, et al. Adenocarcinoma of the thymus: mucinous subtype. Hum Pathol 2005;36:219–223.
Misao T, Yamamoto Y, Nakano H, Toyooka S, Yamane M, Satoh K. Primary thymic adenocarcinoma with production of carbohydrate antigen 19-9 and carcinoembryonic antigen. Jpn J Thorac Cardiovasc Surg 2004;52:30–32.
Yoshino M, Hiroshima K, Motohashi S, Shibuya K, Iyoda A, Sekine Y, et al. Papillary carcinoma of the thymus gland. Ann Thorac Surg 2005;80:741–742.
Kapur P, Rakheja D, Bastasch M, Molberg KH, Sarode VR. Primary mucinous adenocarcinoma of the thymus: a case report and review of the literature. Arch Pathol Lab Med 2006;130:201–204.
Sawai T, Inoue Y, Doi S, Ikuta Y, Kimino K, Nakashima M, et al. Tubular adenocarcinoma of the thymus: case report and review of the literature. Int J Surg Pathol 2006;14:243–246.
Ra SH, Fishbein MC, Baruch-Oren T, Shintaku P, Apple SK, Cameron RB, et al. Mucinous adenocarcinomas of the thymus: report of 2 cases and review of the literature. Am J Surg Pathol 2007;31:1330–1336.
Furtado A, Nogueira R, Ferreira D, Tente D, Eisele R, Parente B. Papillary Adenocarcinoma of the Thymus: Case Report and Review of the Literature. Int J Surg Pathol online first, published on Jul 8, 2008.
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Ishiwata, T., Sekiya, M., Suzuki, T. et al. Thymic adenocarcinoma with sarcomatoid features characterized by intracaval tumor growth: Report of a case. Surg Today 40, 1068–1072 (2010). https://doi.org/10.1007/s00595-009-4181-8
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DOI: https://doi.org/10.1007/s00595-009-4181-8