Primary Thymic Adenocarcinoma Research Articles

Clinical characteristics and prognosis of primary thymic adenocarcinoma: A single-center retrospective analysis.

Primary thymic adenocarcinoma (PTAC) is an extremely rare disease with a poor prognosis. In the present study, we sought to analyze the clinical characteristics and prognostic factors of patients with PTAC. A total of 14 patients with PTAC treated at our center from January 2000 to January 2019 were included in this study. We retrospectively collected information on sex, age, history of smoking, family history of cancer, comorbidities, symptoms, imaging tests, serum tumor marker levels, tumor, node, metastasis (TNM) staging, and treatment records. Follow-up information was obtained by telephone interviews or outpatient clinic visit. Univariate and multivariate Cox regression analyses were performed to investigate the clinicopathological factors associated with survival. Among 14 patients with PTAC, there were five males and nine females, with an average age of 48.7 ± 9.3 years. A total of 23.1% of the patients had a history of smoking. The clinical symptoms of the patients were nonspecific and seven patients had elevated levels of serum tumor markers. Surgery was performed for nine patients, among which only four received R0 resection. The median survival time of the 14 patients was 16.0 months, and the 1-, 3- and 5-year survival rates were 57.1%, 35.7% and 21.4%, respectively. TNM stage was identified as an independent prognostic factor for PTAC patients (the median survival time of stage I-IIIA vs. stage IV was 44.0 months vs. 9.0 months, p = 0.002). PTAC is highly aggressive malignancy with poor prognosis. Surgical treatment is feasible, but R0 resection is challenging. TNM staging is significantly associated with patient survival.

Thymic adenocarcinoma presenting as an incidental mediastinal mass

BackgroundPrimary thymic adenocarcinoma represents an exceptionally rare malignancy, for which the cornerstone of therapy is margin-negative resection, with radiation and systemic therapy reserved for invasive and advanced disease. Thymic adenocarcinoma has not been previously reported in the setting of a concomitant malignancy, as reported herein.Case presentationWe present a case of a 55-year-old previously healthy male diagnosed with acute myeloid leukemia, also found to have a mediastinal mass. Evaluation of the mediastinal mass with tumor markers, biopsies, and next-generation sequencing proved non-diagnostic, while he was simultaneously treated with induction chemotherapy to prevent leukemia-related blast crisis. After completing and recovering from induction chemotherapy, he underwent successful thymectomy during a chemotherapy holiday, with a margin-negative resection of thymic adenocarcinoma. He has subsequently recovered and undergone successful allogeneic hematopoietic stem cell transplant.ConclusionsWe present a case of synchronous adult acute myeloid leukemia and primary thymic adenocarcinoma requiring a tailored approach for management of simultaneous malignancies.

Atypical Presentation of a Primary Thymic Adenocarcinoma

Primary thymic adenocarcinomas are extremely rare and aggressive tumours. In this report, clinical and histopathological findings of this rare entity as well as its treatment approaches are presented. A 55-year man was operated for anterior mediastinal mass. Histopathological examination revealed primary thymic adenocarcinoma. No other tumour focus was found in clinical, radiological, and endoscopic examinations. Due to the capsular invasion, adjuvant mediastinal radiotherapy was applied. In the process of monitoring, brain metastases developed. Stereotactic radiosurgery and chemotherapy were applied. All the lesions are under control at 28 months postoperatively. Complete surgical resection of the tumour is the most important factor. Adjuvant radiotherapy and/or chemotherapy as well as local therapies for metastases (surgical therapy or stereotactic radiosurgery) are seen as approaches to improve survival. Key Words: Adenocarcinoma, Metastasis, Stereotactic radiosurgery, Thymus.

A case report: primary thymic adenocarcinoma with enteric differentiation

A case report: primary thymic adenocarcinoma with enteric differentiation

A case of thymic non-papillary adenocarcinoma

Introduction: Primary thymic adenocarcinoma is a notably rare neoplasm. Here, we described a case of non-papillary thymic adenocarcinoma that was comparable to adenocarcinoma not otherwise specified (NOS) according to the recent WHO classification.

Primary thymic adenocarcinomas: a clinicopathological and immunohistochemical study of 16 cases with emphasis on the morphological spectrum of differentiation

Sixteen cases of primary thymic adenocarcinoma are presented. The patients are 9 men and 7 women between the ages of 22 and 68 years (average, 45 years) who presented with non-specific symptoms including cough, chest pain, and dyspnea. Diagnostic imaging revealed the presence of an anterior mediastinal mass, which was surgically removed in all of the patients. Histologically, none of the tumors was encapsulated and showed different growth patterns including mucinous, non-mucinous, and papillary features. The majority of cases showed mixed growth pattern, and the tumor was limited to the mediastinum with only a few cases extending to lymph nodes or pericardium. In two cases, the adenocarcinoma was associated with a thymoma. Immunohistochemical stains were performed, and their positive staining varied depending on the histology of the tumors, showing positive staining in some cases for keratin 7, keratin 20, CEA, CD5, CD117, and CDX-2. PAX8 and TTF-1 were negative in all the tumors. Follow-up information was obtained in 10 patients over a period of 1 to 12 years, indicating that three patients had died within a period of 14 months, one with brain metastasis, while seven patients have remained alive without recurrence. The cases herein described span the spectrum of thymic epithelial tumors and highlight the importance of recognizing this particular type of carcinoma, as it may follow a different outcome and require different treatment options.

AB035. PS01.17: Primary thymic adenocarcinoma with signet ring cell features to a 39-year-old male: a case report

: We describe a case of primary thymic adenocarcinoma, an extremely uncommon neoplasm with only 43 cases reported in literature. Patient was a 39-year-old male who presented with an anterior mediastinal mass extending to the left supraclavicular area. He later developed bilateral pleural and pericardial effusions which led to his untimely demise. A small biopsy from the left supraclavicular area was done post-mortem which showed back to back arrangement of neoplastic glands and occasional signet-ring cells. The initial diagnosis was metastatic adenocarcinoma with signet-ring cell features, but extensive clinicoradiologic work-up failed to reveal a primary tumor elsewhere. Immunohistochemically, the tumor cells were reactive for CK-7, CEA, and CD5 and non-reactive for CK-20, TTF-1, NAPSIN A, AFP, PAX-8, CD-117, CA19-9, CA-125, CDX2, P63, CD45 and CD99. The morphologic and immunophenotypic similarities of thymic adenocarcinomas with signet ring cell features from the lungs, stomach, and pancreas can pose diagnostic challenges for surgical pathologists especially for small biopsy specimens where origin from a dysplastic thymic epithelium or a thymic cyst cannot be ascertained. Therefore, a thorough clinical and radiological work-up with immunohistochemical investigation is critical. The findings in this case further broaden the morphologic spectrum of thymic adenocarcinomas.

Histologic characteristics of thymic adenocarcinomas: Clinicopathologic study of a nine-case series and a review of the literature

Primary thymic adenocarcinoma is an extraordinarily rare malignancy; only 49 cases have been reported in the medical literature to date. Because of its rarity, clinical and pathologic characteristics of thymic adenocarcinoma are unclear. We present nine cases of primary thymic adenocarcinoma and discuss clinicopathologic findings in the context of the existing literature.Two-hundred twenty-six thymic carcinoma cases were diagnosed at Samsung Medical Center in Korea, from January, 2001 to July, 2016. Nine of these 226 cases were primary thymic adenocarcinomas. The mean age of primary thymic adenocarcinoma patients was 53.6 years, slightly younger than the mean age of patients with thymic squamous cell carcinomas. The male to female ratio was 2:1. Symptoms, if present, were usually due to compression by the tumor. Tumors showed an extra- or intra-cellular mucin and tubular growth pattern, with CK20- and CDX2-immunoreactivity, similar to adenocarcinomas of the lower intestinal tract.Twenty-five previously reported cases, classified as mucinous adenocarcinoma and adenocarcinoma, not otherwise specified, also had similar characteristics to enteric-type adenocarcinoma and generally expressed CK20, CDX2, CEA, and/or MUC2. Some of these cases had a thymic cyst. These characteristics are different from those of papillary thymic carcinomas, which are morphologically similar to papillary thyroid carcinomas, express CK7 but not CK20, and are often associated with thymoma. The prognosis of thymic adenocarcinoma, enteric type appeared to be worse than the prognosis of papillary thymic carcinoma or carcinoma with adenoid cystic carcinoma-like features.In summary, we demonstrated that common primary thymic adenocarcinomas show enteric-type differentiation with mucin. This tumor type has distinct clinical, pathological, immunohistochemical and prognostic characteristics and is different from other subtypes of thymic adenocarcinoma, papillary thymic carcinoma, and carcinoma with adenoid cystic carcinoma-like features.

A Rare Case of Primary Tubular Adenocarcinoma of the Thymus, Enteric Immunophenotype: A Case Study and Review of the Literature.

Thymic carcinomas are uncommon malignant tumors, and thymic adenocarcinomas are extremely rare. Here, we describe a case of primary thymic adenocarcinoma in a 59-year-old woman. Histological examination of the tumor revealed tubular morphology with expression of cytokeratin 20 and caudal-type homeobox 2 according to immunohistochemistry, suggesting enteric features. Extensive clinical and radiological studies excluded the possibility of an extrathymic primary tumor. A review of the literature revealed only two global cases of primary tubular adenocarcinomas of the thymus with enteric immunophenotype.

A rare case of primary thymic adenocarcinoma mimicking small cell lung cancer.

Primary thymic adenocarcinoma is a very rare malignancy of the anterior mediastinum with no standardized treatment. A 36-year-old male patient presented with hoarseness over the past 3 months. A chest computed tomography (CT) scan showed an infiltrative mass to the proximal vessels and aortic arch in left upper mediastinum (4.1×3.1×5.4 cm). Brain magnetic resonance imaging (MRI) showed focal lesions, suggesting metastasis in the left frontal lobe. A thoracoscopic biopsy of the mediastinal mass confirmed a primary thymic adenocarcinoma forming a glandular structure with atypia of tumor cells. The patient received four cycles of systemic chemotherapy, consisting of etoposide and cisplatin, with concurrent radiotherapy (6,000 cGy/30 fractions) to the mediastinal lesion and the metastatic brain lesion (4,200 cGy/12 fractions). A follow-up chest CT scan and brain MRI showed a decrease in the size of the left upper mediastinal mass and brain lesion. We report a rare case of the primary thymic adenocarcinoma with a literature review.

Primary thymic adenocarcinoma: report of a case

患者男,64岁.体检发现纵隔肿块1个月于2010年10月20日人院.患者偶有活动后胸闷、心慌、呼吸困难.胸部CT示前上纵隔类圆形软组织密度肿块,直径4 cm,内见片状低密度影,肿块境界清楚,周围见点状钙化灶.肺内未见占位性病变,肺门影不大,胸腔无积液(图1).全腹部B超及CT未见异常,胃肠内镜未见异常。

Thymic adenocarcinoma with sarcomatoid features characterized by intracaval tumor growth: Report of a case

Primary thymic adenocarcinoma is an extremely rare tumor. This report describes a case of thymic adenocarcinoma with a peculiar pathological feature and clinical course. A 54-year-old man complained of cough, dyspnea, and chest pain. Computed tomography scans revealed an anterior mediastinal mass with intracaval growth into the superior vena cava. No definitive diagnosis could be made after several examinations and palliative radiotherapy was performed. He passed away 56 days after the appearance of the initial symptoms. An autopsy revealed that the mediastinal tumor obstructed not only the superior vena cava but also the pulmonary arteries. The histological findings revealed the tumor to be an adenocarcinoma with sarcomatous features. The tumor was immunohistochemically positive for CD5 and negative for thyroid transcription factor-1. These results suggested the tumor to be a thymic adenocarcinoma with sarcomatoid features; furthermore, the tumor invaded the great vessels, thus resulting in a poor prognosis.

Primary thymic adenocarcinoma coexisting with type AB thymoma: a rare case with long-term survival

Thymic carcinoma is a rare tumor. The most common histological subtype is squamous cell carcinoma, and only a few cases of thymic adenocarcinoma have been reported. A case of papillary adenocarcinoma of thymic origin that coexisted with type AB thymoma as a separate nodule is presented herein. The patient was found to have an abnormal mediastinal shadow on chest X-ray. A computed tomography scan revealed a round, 6.5-cm-diameter mass in the right anterior mediastinum. The preoperative diagnosis was thymoma, and thymothymectomy was performed. On pathological examination, two tumors, which were diagnosed as papillary adenocarcinoma and type AB thymoma, respectively, were present in the thymus without any connection with each other. The patient has been alive without any signs of recurrence for 11 years after surgery. We diagnosed the adenocarcinoma in this case was a primary thymic carcinoma.

Adenocarcinoma of the thymus: mucinous subtype

Primary thymic adenocarcinoma, mucinous subtype, is extremely rare with only one case reported to date. We describe herein a case of thymic mucinous adenocarcinoma. A 59-year-old man was identified to have an anterior mediastinal tumor and was diagnosed as mucinous adenocarcinoma. Clinical and radiographic examinations disclosed no evidence of tumor elsewhere. The patient received radiotherapy, but the general condition deteriorated and died 11 months after tumor detection. Thoracic autopsy revealed an anterior mediastinal tumor measuring greater than 10 cm, uncapsulated, and white. The tumor had clear margins and was clearly isolated from the lung. Histologically, the tumor demonstrated papillary, acinar, and cribriform structure and produced abundant extracellular mucin. Immunohistochemically, most tumor cells were positive for cytokeratin 7, were partially positive for CD5, and were negative for TTF-1, Sp-A, CDX-2, MUC2, napsin A, and cytokeratin 20. Collectively, the diagnosis of the tumor was primary mucinous adenocarcinoma of the thymus. We propose that the mucinous subtype should be recognized as one of the histopathological entities of thymic adenocarcinoma.

Pelvic tumor with differentiation as rectal adenocarcinoma and chorioncarcinoma but with common molecular characteristics

Primary thymic adenocarcinoma is an extraordinarily rare malignancy; only 49 cases have been reported in the medical literature to date. Because of its rarity, clinical and pathologic characteristics of thymic adenocarcinoma are unclear. We present nine cases of primary thymic adenocarcinoma and discuss clinicopathologic findings in the context of the existing literature.Two-hundred twenty-six thymic carcinoma cases were diagnosed at Samsung Medical Center in Korea, from January, 2001 to July, 2016. Nine of these 226 cases were primary thymic adenocarcinomas. The mean age of primary thymic adenocarcinoma patients was 53.6 years, slightly younger than the mean age of patients with thymic squamous cell carcinomas. The male to female ratio was 2:1. Symptoms, if present, were usually due to compression by the tumor. Tumors showed an extra- or intra-cellular mucin and tubular growth pattern, with CK20- and CDX2-immunoreactivity, similar to adenocarcinomas of the lower intestinal tract.Twenty-five previously reported cases, classified as mucinous adenocarcinoma and adenocarcinoma, not otherwise specified, also had similar characteristics to enteric-type adenocarcinoma and generally expressed CK20, CDX2, CEA, and/or MUC2. Some of these cases had a thymic cyst. These characteristics are different from those of papillary thymic carcinomas, which are morphologically similar to papillary thyroid carcinomas, express CK7 but not CK20, and are often associated with thymoma. The prognosis of thymic adenocarcinoma, enteric type appeared to be worse than the prognosis of papillary thymic carcinoma or carcinoma with adenoid cystic carcinoma-like features.In summary, we demonstrated that common primary thymic adenocarcinomas show enteric-type differentiation with mucin. This tumor type has distinct clinical, pathological, immunohistochemical and prognostic characteristics and is different from other subtypes of thymic adenocarcinoma, papillary thymic carcinoma, and carcinoma with adenoid cystic carcinoma-like features.