Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
Med Oncol. 2013 Mar;30(1):479. doi: 10.1007/s12032-013-0479-x. Epub 2013 Feb 3.
Atypical carcinoid tumors above the diaphragm are extremely rare and are associated with unfavorable clinical outcomes compared to typical carcinoid tumors. We described various clinical and histological features and investigated outcomes in patients with atypical carcinoid tumor of the lung and thymus. Medical records were reviewed in patients diagnosed with atypical carcinoid tumor of the lung or thymus at Samsung Medical Center between December 2003 and April 2010. We reviewed patient characteristics and treatment modalities and analyzed patient outcome in terms of disease-free survival and overall survival. Of the nineteen study patients, there were twelve patients with atypical carcinoid tumors of the lung and seven patients with thymic ones. All patients except one underwent complete resection as the main treatment. All patients who had tumors with lesser mitoses (≤5/10 high-power fields) are presently alive; moreover, they are all free of recurrence except for one patient who is also alive with recurrent tumor without any palliative treatment. Distant metastasis after curative resection developed in six patients and two of them died of progressive disease 25-31 months after recurrence even after palliative systemic chemotherapy. Atypical carcinoid tumor of the lung and thymus was a malignant disease that was prone to metastasize to distant sites even after curative resection and adjuvant treatment. Number of mitosis was a predicting factor for recurrence of disease and death in patients with atypical carcinoid tumor of the lung and thymus.
膈上非典型类癌肿瘤极为罕见，与典型类癌肿瘤相比，其临床结局较差。我们描述了肺和胸腺非典型类癌肿瘤患者的各种临床和组织学特征，并对其预后进行了研究。在 2003 年 12 月至 2010 年 4 月期间，在三星医疗中心诊断为肺或胸腺非典型类癌肿瘤的患者中，我们回顾了病历。我们回顾了患者的特征和治疗方式，并根据无病生存率和总生存率分析了患者的预后。在 19 名研究患者中，有 12 名患有肺非典型类癌肿瘤，7 名患有胸腺非典型类癌肿瘤。除了一名患者外，所有患者均接受了完全切除术作为主要治疗方法。所有肿瘤有较少分裂象（≤10 高倍视野 5/个）的患者均存活；此外，除了一名患者在没有任何姑息治疗的情况下仍有复发性肿瘤且没有复发外，所有患者均未复发。6 例患者在根治性切除术后发生远处转移，其中 2 例患者在复发后 25-31 个月因进展性疾病死亡，即使接受姑息性全身化疗也是如此。肺和胸腺的非典型类癌是一种恶性疾病，即使在根治性切除和辅助治疗后，也容易转移到远处部位。有丝分裂数是肺和胸腺非典型类癌患者疾病复发和死亡的预测因素。
