Shimono M, Hiraki A, Ueoka H, Tanimoto Y, Aoe M, Sakae K, Kaneda K, Sakugawa M, Kiura K, Harada M
Department of Internal Medicine (II), Okayama University Medical School, Japan.
Anticancer Res. 2001 Jul-Aug;21(4A):2519-22.
Most neoplasms arising from the thymic epithelium are considered to be 'thymomas', which are composed of cytologically benign, neoplastic epithelial cells and nonneoplastic lymphocytes. In contrast, thymic epithelial neoplasms displaying cytologically malignant features have recently been classified as thymic carcinomas of various types of histology. However, primary thymic adenocarcinoma is extremely rare and only four cases of it have been reported in the literature. We report a rare case of primary thymic adenocarcinoma of 4-year complete remission with concurrent chemoradiotherapy followed by surgery. A 61-year-old Japanese man was referred to us complaining of facial edema and general fatigue. Computed tomography scans revealed a huge mass in the anterior mediastinum obstructing the superior vena cava. He was diagnosed with thymic adenocarcinoma on needle biopsy. He was treated with induction chemoradiotherapy consisting of cisplatin, 5-FU and concurrent thoracic radiation, which yielded a partial response. He then underwent surgical resection of the remaining mass. However, pathologic examination of the resected mass revealed no malignant cells. The patient is doing well without symptoms or signs of relapse 53 months after diagnosis.
大多数起源于胸腺上皮的肿瘤被认为是“胸腺瘤”，由细胞学上良性的肿瘤性上皮细胞和非肿瘤性淋巴细胞组成。相比之下，具有细胞学恶性特征的胸腺上皮肿瘤最近被归类为各种组织学类型的胸腺癌。然而，原发性胸腺腺癌极为罕见，文献中仅报道过4例。我们报告1例罕见的原发性胸腺腺癌病例，该患者经同步放化疗后手术，实现了4年的完全缓解。一名61岁的日本男性因面部水肿和全身乏力前来就诊。计算机断层扫描显示前纵隔有一个巨大肿块，压迫上腔静脉。经针吸活检，他被诊断为胸腺腺癌。他接受了由顺铂、5-氟尿嘧啶组成的诱导放化疗以及同步胸部放疗，治疗后获得部分缓解。随后，他接受了剩余肿块的手术切除。然而，切除肿块的病理检查未发现恶性细胞。该患者在确诊53个月后情况良好，无复发症状或体征。
