Zhang Kai, Chen Huiguo, Wu Yonghui, Li Xiaojun, Zhang Jian, Gu Lijia, Wu Weibin
Department of Cardiothoracic Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China.
Transl Cancer Res. 2020 Apr;9(4):3047-3053. doi: 10.21037/tcr.2020.02.10.
Primary thymic atypical carcinoid (TAC) is a kind of neuroendocrine tumors of the mediastinum, which has a poor prognosis due to its invasive behavior, metastasis and postoperative recurrence. We present a relatively rare case who came to hospital because of chest pain and tightness from a large mediastinal mass of 115 mm × 95 mm compressing left brachiocephalic veins, pericardium and upper-lobe of left lung. Although the operation was rather challenging, we performed complete resection including local lymph node dissection by open median sternotomy. The pathology of combining hematoxylin/eosin staining and immunohistochemical was confirmed to be primary TAC, grade 2 according to 2015 WHO Classification of Tumors of the Thymus. After radical surgery, the case underwent 6 cycles of platinum-based adjuvant chemotherapy. To date, the man has survived over 11 months without recurrence and distant metastasis. In conclusion, open surgery is a safe and effective method for locally advanced TAC and radical resection combination with adjuvant chemotherapy may lead to a long-term survival.
原发性胸腺非典型类癌（TAC）是一种纵隔神经内分泌肿瘤，因其侵袭性、转移性及术后复发，预后较差。我们报告一例相对罕见的病例，患者因胸痛和胸闷入院，其纵隔有一个大小为115 mm×95 mm的巨大肿块，压迫左头臂静脉、心包和左肺上叶。尽管手术颇具挑战性，但我们通过正中开胸术进行了完整切除，包括局部淋巴结清扫。苏木精/伊红染色及免疫组化联合病理检查确诊为原发性TAC，根据2015年世界卫生组织胸腺肿瘤分类为2级。根治性手术后，该病例接受了6个周期的铂类辅助化疗。迄今为止，该患者已存活超过11个月，无复发及远处转移。总之，开放手术是治疗局部晚期TAC的一种安全有效的方法，根治性切除联合辅助化疗可能带来长期生存。
