Anterior mediastinal large cell neuroendocrine carcinoma with elevated AFP: A case report and review

Komisarof, Justin; Qiu, Haoming; Velez, Moises J.; Mulford, Deborah

doi:10.3892/mco.2020.2196

Cited by 1 publication

(1 citation statement)

References 29 publications

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“…Surprisingly, histological findings in our patient showed small cell carcinoma with immunohistochemical positivity for AFP, which to the best of our knowledge has never been described occurring in the thymus. A literature search found two cases of AFP-positive thymic LCNEC, both of which were histologically diagnosed based on resected specimens, though the initial clinical diagnosis was germ cell carcinoma [ 4 , 5 ]. Chemotherapy is usually conducted for a germ cell carcinoma and its response rate is relatively high.…”

Section: Discussionmentioning

confidence: 99%

A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report

Kobayashi,

Funaki,

Fukui

et al. 2023

surg case rep

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Background An alpha-fetoprotein (AFP)-positive neuroendocrine tumor of the thymus is a rare thoracic malignancy. Few cases of AFP-positive thymic large cell neuroendocrine carcinoma have been reported, with no known previous report of an AFP-positive thymic small cell carcinoma. We encountered a patient with an AFP-positive small cell carcinoma and report here the clinical course. Case presentation A 40-year-old man was transferred to our hospital for a large anterior mediastinal tumor and showed an elevated serum AFP level. Computed tomography-guided biopsy results led to diagnosis of small cell carcinoma. Induction chemoradiotherapy was performed before surgery because of pulmonary artery invasion. The response to Induction chemoradiotherapy varied among sites, with the main tumor showing shrinkage and the metastasis site growth. This discrepancy suggested a histologic type unresponsive to or cancer cells potentially resistant to chemotherapy, thus a surgical re-biopsy was performed and histological findings revealed AFP-positive small cell carcinoma. Additional chemotherapy was performed, though could not control cancer progression, and the patient died 8 months after the first medical examination. Conclusions Our present clinical experience indicates the importance of histological examination for determining AFP-positive anterior mediastinal tumor treatment. Although AFP-positive neuroendocrine tumor of the thymus is relatively rarer than germ cell carcinoma, differential diagnosis with use of a histological examination should be considered because of the potentially poorer prognosis. The present clinical findings for an AFP-positive neuroendocrine tumor of the thymus case are considered useful for establishing an optimal treatment strategy in the future.

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Section: Discussionmentioning

confidence: 99%