Nagamata Makoto, Okuma Yusuke, Yamada Yuko, Hosomi Yukio, Hishima Tsunekazu
Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
Oncol Lett. 2014 Aug;8(2):513-516. doi: 10.3892/ol.2014.2217. Epub 2014 Jun 3.
Thymic carcinoma is a rare cancer that is more aggressive and shows a poorer prognosis compared with thymoma. Molecular analysis has demonstrated that this entity is clearly distinct from thymoma. However, no definitive clinical management has been reported, and the roles of chemotherapy and radiotherapy for advanced thymic carcinoma remain unclear given the rarity of this clinicopathology. The current study reports the case of a 65-year-old male who presented with advanced thymic carcinoma with solitary brain and pulmonary metastases, but demonstrated long-term survival following multiple lines of chemotherapy and radiotherapy with palliative intent. Although the solitary brain metastasis was well controlled for several years using whole-brain irradiation, cognitive function gradually declined with cerebral atrophy. Thymic carcinoma is known to show a poor prognosis and aggressive clinical progress, however, it occasionally demonstrates a clinically indolent course. Modalities of treatment should thus be selected prudently to avoid toxicity, in consideration of the possibility of long-term survival. Stereotactic radiation therapy for brain metastases, including cyberknife or γ-knife surgery, appears to represent the optimal local treatment for such patients with unexpectedly longer survival due to indolent thymic carcinoma.
胸腺癌是一种罕见的癌症，与胸腺瘤相比，其侵袭性更强，预后更差。分子分析表明，该实体与胸腺瘤明显不同。然而，尚未有明确的临床治疗方案报道，鉴于这种临床病理情况较为罕见，化疗和放疗在晚期胸腺癌中的作用仍不明确。本研究报告了一例65岁男性患者，其患有伴有孤立性脑转移和肺转移的晚期胸腺癌，但在进行了多线姑息性化疗和放疗后实现了长期生存。尽管通过全脑照射对孤立性脑转移进行了数年的良好控制，但随着脑萎缩，认知功能逐渐下降。胸腺癌已知预后较差且临床进展具有侵袭性，然而，它偶尔也会表现出临床惰性病程。因此，考虑到长期生存的可能性，应谨慎选择治疗方式以避免毒性。对于因惰性胸腺癌而意外获得较长生存期的此类患者，立体定向放射治疗，包括射波刀或伽玛刀手术，似乎是最佳的局部治疗方法。
