Ramahandrisoa Andriatsihoarana Voahary Nasandratriniavo, Hasiniatsy Nomeharisoa Rodrigue Emile, Refeno Valéry, Vololonantenaina Clairette Raharisolo, Rakotoarisoa Andriamihaja Jean Claude, Rakotovao Hanitrala Jean Louis, Rafaramino Florine
Faculté de Médecine d'Antananarivo, Madagascar.
Unité d'Oncologie Médicale, Centre Hospitalier de Soavinandriana, Madagascar.
Pan Afr Med J. 2017 Jan 18;26:25. doi: 10.11604/pamj.2017.26.25.11500. eCollection 2017.
Thymic neuroendocrine tumors (TNET) are rare, with little-known prognosis. This study aims to report a case of TNET and to highlight the diagnostic and therapeutic difficulties in low-resource settings. A 60-year-old man presented with chest pain, greasy cough and recent weight loss. Chest CT scan showed anterior mediastinal tissue mass. Histologic evaluation of a 4 months-biopsy specimen obtained from anterior mediastinotomy showed a well differentiated TNET, labeled intensely positive for chromogranin and synaptophysin. The search for other neuroendocrine tumors and the extent of extension were negative. The tumor was immediately inextricable and radiation therapy was unavailable. The patient underwent two lines of first line chemotherapy. At 16 months follow-up, the patient was asymptomatic but showed tumor progression. The diagnosis of TNET may be delayed when immunohistochemistry is not routinely performed. Chemotherapy is associated with symptoms improvement in palliative care situation.
胸腺神经内分泌肿瘤(TNET)较为罕见,其预后鲜为人知。本研究旨在报告一例TNET病例,并强调资源匮乏地区在诊断和治疗方面的困难。一名60岁男性出现胸痛、咳痰和近期体重减轻症状。胸部CT扫描显示前纵隔组织肿块。经前纵隔切开术获取的4个月活检标本的组织学评估显示为高分化TNET,嗜铬粒蛋白和突触素标记呈强阳性。未发现其他神经内分泌肿瘤及转移情况。肿瘤立即无法切除且无法进行放射治疗。患者接受了两线一线化疗。随访16个月时,患者无症状,但肿瘤进展。若不常规进行免疫组化,TNET的诊断可能会延迟。在姑息治疗情况下,化疗可改善症状。