Jodai Yasumiko, Saruwatari Koichi, Muramoto Kei, Imamura Kosuke, Sakata Shinya, Yoshida Chieko, Miyasato Yuko, Honda Yumi, Tomita Yusuke, Ichiyasu Hidenori, Sakagami Takuro
Department of Respiratory Medicine, Faculty of Life Sciences, Kumamoto University, Japan.
Department of Diagnostic Pathology, Kumamoto University Hospital, Japan.
Intern Med. 2025 Jul 1;64(13):2042-2045. doi: 10.2169/internalmedicine.4566-24. Epub 2024 Dec 26.
A 59-year-old woman presented with multiple mediastinal masses 6 months after post-thymectomy for type B2 thymoma. A diagnosis of small-cell carcinoma (SmCC) via a computed tomography-guided biopsy and fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography revealed no primary lesions outside the anterior mediastinum. The pathologically reevaluated post-thymectomy specimen showed no neuroendocrine differentiation. SmCC is presumed to arise either from malignant transformation of the thymoma or de novo formation. She was treated with carboplatin and paclitaxel to achieve complete response. This case highlights the importance of a re-biopsy to guide appropriate treatment in cases of rapid progression during the course of thymoma.
一名59岁女性在B2型胸腺瘤胸腺切除术后6个月出现多个纵隔肿块。通过计算机断层扫描引导活检和氟-18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描诊断为小细胞癌（SmCC），未发现前纵隔以外的原发灶。胸腺切除术后标本经病理重新评估未显示神经内分泌分化。SmCC推测要么源于胸腺瘤的恶性转化，要么是新生形成。她接受了卡铂和紫杉醇治疗，达到了完全缓解。该病例强调了在胸腺瘤病程中快速进展的情况下进行再次活检以指导适当治疗的重要性。
