Adenocarcinoma of the Thymus, Enteric Type

Abstract

We report 2 cases of primary thymic adenocarcinoma with enteric differentiation. One carcinoma occurred in a 41-year-old man as a 7-cm-diameter cystic tumor and the other one in a 39-year-old woman as a 6-cm-diameter solid mass. Both tumors were located in the anterior mediastinum. Clinical staging did not reveal any extrathymic tumor. Histologically, the tumors were classified as adenocarcinoma, not otherwise specified, and a mucinous (colloid) carcinoma, respectively. Immunohistochemically, both tumors were positive for cytokeratin 20 (CK20), CDX2, and carcinoembryonic antigen, reflecting enteric differentiation. A review of the literature on 43 other cases of primary thymic adenocarcinomas suggested 11 further cases with enteric differentiation, as assessed by CK20 and/or CDX2 expression. We propose that thymic adenocarcinoma with enteric differentiation represents a novel subtype of thymic carcinoma. It is mostly of mucinous morphology and frequently associated with thymic cysts. The clinical outcome is variable. Recognition of primary thymic adenocarcinoma with enteric differentiation is helpful for the differentiation from metastatic disease, mainly from the gastrointestinal tract.

Colon cancer chemotherapy for a patient with CDX2-expressing metastatic thymic adenocarcinoma: a case report and literature review

“…There have been 46 reported cases of thymic adenocarcinoma [1,6] in addition to our own. Of the 47 cases, 12 (25.5 %) were primary thymic adenocarcinoma with a CDX2-positive phenotype.…”

“…Recently, Moser et al [1] reported a subtype of thymic adenocarcinoma with CDX2-positive enteric features. CDX2, a homeodomain transcription factor required for the development and maintenance of the intestinal epithelium, is overexpressed by human colon adenocarcinoma [2].…”

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

“…Moser et al . [ 12 ] recently reported two cases of primary thymic adenocarcinoma with CK20 and CDX2 expression, which reflects enteric differentiation, and suggested this is a novel subtype along with 11 reported thymic adenocarcinomas with enteric immunophenotype.…”

“…According to a series of case reports in which descriptive classifications are commonly used, thymic adenocarcinomas comprise papillary [ 4 - 6 ], mucinous [ 3 , 7 - 9 ], glandular (or tubular) [ 10 - 12 ], and papillotubular [ 2 , 13 , 14 ] adenocarcinomas. In 2003, Maghbool et al .…”

Characterization of genetic aberrations in a single case of metastatic thymic adenocarcinoma

“…Thirty-five cases have been reported in the literature since the first case in 1989 [1–5]. They have shown papillary, papillotubular, tubular, or mucinous histological features that were different from the other subtypes of thymic carcinoma.…”