Abstract
Thymomas are rare and usually slowly growing tumors, originating from the epithelial layer of the thymus. Prognosis depends on the extent of invasion of adjacent tissues whereby multimodality treatment including surgery with or without adjuvant chemoradiotherapy is the preferred approach for locally advanced thymomas. For metastatic thymomas, only few chemotherapeutic options are available. We report 2 cases of patients with metastatic thymic malignancies with a dramatic response on pemetrexed treatment. The choice for this antifolate therapy is based upon a small series. Because metastatic thymic neoplasm is a rare disease, large randomised trials are not feasible. Case reports on the treatment of these malignancies are very important and can provide readers with the opportunity to deal with rare dis- eases.
Highlights
Thymomas are rare tumors arising from the epithelial tissue from the thymus presenting in the anterior mediastinum and account for 20% of mediastinal neoplasms
Prognosis depends on the extent of invasion of adjacent tissues whereby multimodality treatment including surgery with or without adjuvant chemoradiotherapy is the preferred approach for locally advanced thymomas
We report 2 cases of patients with metastatic thymic malignancies with a dramatic response on pemetrexed treatment
Summary
Thymomas are rare tumors arising from the epithelial tissue from the thymus presenting in the anterior mediastinum and account for 20% of mediastinal neoplasms. The incidence of these tumors is merely 2.5 and 3.2 per 106 people in Denmark and the Netherlands respectively [1,2]. Thymomas are primary tumors of thymic epithelial cells. In advanced or recurrent thymic malignancies, a multimodality approach incorporating surgery, radiation and chemotherapy is required [11]. When this therapy fails, there are no known alternatives to treat recurrent thymic neoplasms because of the rarity of the disease and the poor understanding of the molecular biology of these malignancies. That’s why we want to share our experience with pemetrexed as second line therapy for recurrent thymic tumors by publishing the following case reports
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