切除的胸腺大细胞神经内分泌癌：1例报告

Resected thymic large cell neuroendocrine carcinoma: report of a case.

作者信息

Domen Hiromitsu, Hida Yasuhiro, Sato Masaaki, Takahashi Haruka, Ishikawa Tatsuru, Shionoya Yosuke, Hashimoto Midori, Nishiyama Kaoru, Aoki Yuma, Inoko Kazuho, Furukawa Syotaro, Ichinokawa Kazuomi, Yamada Hidehisa

机构信息

Department of Surgery, Nippon Telegraph and Telephone East Corporation Sapporo Medical Center, South 1, West 15, Chuo-ku, Sapporo, Hokkaido, 060-0061, Japan.

Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Hokkaido University, North 14, West 5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan.

出版信息

Surg Case Rep. 2018 Nov 16;4(1):133. doi: 10.1186/s40792-018-0540-2.

DOI:10.1186/s40792-018-0540-2

PMID:30446840

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6240022/

Abstract

BACKGROUND

Thymic large cell neuroendocrine carcinoma (LCNEC) is extremely rare. The detailed clinical features of thymic LNCECs remain unknown.

CASE PRESENTATION

A 90-year-old man with a history of diabetes mellitus, chronic renal failure, and an abdominal aortic aneurysm underwent computed tomography for follow-up, which showed an anterior mediastinal tumor, measuring 31 mm × 28 mm in diameter. Magnetic resonance imaging showed an iso-intensity mass on T1-weighted images and high intensity on T2-weighted images. 18F-Fluorodeoxyglucose-positron emission tomography showed marked uptake in the mass, which was diagnosed as invasive thymoma or thymic carcinoma. Video-assisted thoracic surgery through the left thoracic cavity was converted to median sternotomy due to severe adhesions between the left lung and the chest wall. Partial thymectomy and combined partial resection of left upper lobectomy and the first and the second costal cartilages were performed. The pathologic diagnosis was thymic LCNEC, Masaoka stage III. The patient developed pleural dissemination and left lung metastases in 5 months and died 12 months after surgery.

CONCLUSIONS

Thymic LCNEC has high malignant potential. More cases need to be studied.

摘要

背景

胸腺大细胞神经内分泌癌（LCNEC）极为罕见。胸腺LCNEC的详细临床特征仍不清楚。

病例介绍

一名90岁男性，有糖尿病、慢性肾衰竭和腹主动脉瘤病史，接受计算机断层扫描随访，发现前纵隔肿瘤，直径31毫米×28毫米。磁共振成像显示T1加权图像上为等强度肿块，T2加权图像上为高强度。18F-氟脱氧葡萄糖正电子发射断层扫描显示肿块有明显摄取，诊断为侵袭性胸腺瘤或胸腺癌。由于左肺与胸壁严重粘连，通过左胸腔的电视辅助胸腔镜手术改为正中胸骨切开术。进行了部分胸腺切除术，并联合左上叶切除术及第一、第二肋软骨部分切除术。病理诊断为胸腺LCNEC，Masaoka III期。患者术后5个月出现胸膜播散和左肺转移，术后12个月死亡。