Abstract

BackgroundThymic carcinoma is a rare neoplasm with extremely poor prognosis. To evaluate the biological characteristics of thymic carcinoma, we reviewed 8 patients.MethodsThere were 2 men and 6 women: ages ranged from 19 to 67 years old (mean 54.8 years). None of these patients had concomitant myasthenia gravis and pure red cell aplasia. No patient had stage I disease, 1 stage II, 5 stage III, and 2 stage IV. The pathologic subtypes of thymic carcinoma included 5 squamous cell carcinomas, 1 adenosquamous cell carcinomas, 1 clear cell carcinoma, and 1 small cell carcinoma. Immunohistochemical study was performed using antibodies against p53, bcl-2, Ki-67, carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), nm23-H1, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (FGF-2) and factor VIII.ResultsCurative resection could be done in 4 patients (50%). Our data indicates a trend toward an association between complete resection and patient survival. Expression of p53, bcl-2, CEA, EMA, nm23-H1, VEGF and FGF-2 was detected in 5/8, 3/8, 4/8, 5/8, 6/8, 5/8 and 3/8, respectively. Mean Ki-67 labeling index and microvessel density was 7.01 and 34.36 (per 200× field), respectively. When compared with our previous studies, immunohistochemical staining of these proteins in thymomas, the expression rates of these proteins in thymic carcinomas were higher than those in thymomas.ConclusionsIn this small series, it is suggested that a complete resection suggests a favorable result. Immunohistochemical results reveal that the expression of these proteins might indicate the aggressiveness of thymic carcinoma.

Highlights

  • Thymic carcinoma is a rare neoplasm with extremely poor prognosis

  • BMC Surgery 2002, 2 http://www.biomedcentral.com/1471-2482/2/3 ment protocols and thymic carcinoma is treated by the same guidelines used for thymomas, despite having a more aggressive histologic appearance and clinical outcome [6,7,8]

  • Clinical Results Preoperative biopsy using a 14-gauge Tru-cut biopsy needle was performed for 3 patients, only one was diagnosed as thymic carcinoma and others were failed to obtain a decisive diagnosis

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Summary

Introduction

To evaluate the biological characteristics of thymic carcinoma, we reviewed 8 patients. Thymic carcinoma is a rare type of malignant tumor [1,2]. It is more invasive and with a poorer prognosis than ordinary thymoma [3,4,5,6,7,8]. In spite of numerous previous studies about expression of oncogene proteins in human cancers, very little attention has been given to the biological characteristics of thymic carcinoma [9,10,11,12,13]. To evaluate the outcome and biological characteristics of thymic carcinomas, we reviewed patients undergoing treatment including surgery at our hospital. Since previous studies of ours demonstrated the expression p53, bcl-2, Ki-67, carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), nm23-H1, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (FGF-2) and microvessels in thymomas [14,15], we performed immunohistochemistry using same antibodies as in our previous studies

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