Togashi Ken-ichi, Hosaka Y, Saito M, Sato K, Usuda H, Emura I
Department of Thoracic Surgery, Nagaoka Red Cross Hospital, Nagaoka, Japan.
Kyobu Geka. 2007 Mar;60(3):187-91.
We report a man who developed brain and bone metastases 6 years after resection of recurrent thymoma. The patient underwent surgery for B2-thymoma [World Health Organization (WHO) classification] without microscopic capsular invasion at 50-year-old. The next year, he underwent the second surgery for recurrent B2-thymoma as pleural dissemination. Seven months after the second surgery, he developed recurrence of pleural dissemination. The patient refused any further aggressive treatment, including surgery, chemotherapy, and radiotherapy. The pleural disease did not increase over 6 years, then suddenly enlarged. Thereafter, the patient developed left hemiparesis due to brain metastases, followed by bone metastases. Immunochemical studies of the metastatic tumors demonstrated that these lesions seemed to be poorly differentiated thymic carcinoma (small cell carcinoma) on WHO classification. We concluded that the thymoma transformed to thymic carcinoma with brain and bone metastases during 6 years.
我们报告一例男性患者，其在复发性胸腺瘤切除术后6年发生脑转移和骨转移。该患者50岁时因B2型胸腺瘤（世界卫生组织（WHO）分类）接受手术，术中未见显微镜下包膜侵犯。次年，他因复发性B2型胸腺瘤伴胸膜播散接受了第二次手术。第二次手术后7个月，他出现胸膜播散复发。患者拒绝包括手术、化疗和放疗在内的任何进一步积极治疗。胸膜疾病在6年内未进展，随后突然增大。此后，患者因脑转移出现左侧偏瘫，随后发生骨转移。对转移瘤的免疫化学研究表明，根据WHO分类，这些病变似乎是低分化胸腺癌（小细胞癌）。我们得出结论，该胸腺瘤在6年内转变为伴有脑转移和骨转移的胸腺癌。
