Ectopic Thymic Carcinoma in the Neck

Yao, Wen‐Teng; Chen, Chih‐Hao; Lee, Jie-Jen; Chen, Be‐Fong; Liu, Tsang-Pai

doi:10.1016/j.athoracsur.2009.12.078

Cited by 13 publications

(13 citation statements)

References 6 publications

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“…On the other hand, cases with ectopic thymic carcinoma and thymoma have also been reported in the literature 5,6 . However, these tumors occur more frequently in adults than in children 5,6 .…”

Section: Discussionmentioning

confidence: 99%

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Aberrant cervical thymus and the role of ultrasonography: A case report

Ünal¹,

Düzkalır²,

Kurt-Güney³

et al. 2016

Turk J Pediatr

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Section: Discussionmentioning

confidence: 99%

“…However, these tumors occur more frequently in adults than in children 5,6 . Also, to the best of our knowledge there is not enough data to point out that the malignant transformation rate of ectopic thymic tissue is any greater than normal thymic tissue.…”

Section: Discussionmentioning

confidence: 99%

Aberrant cervical thymus and the role of ultrasonography: A case report

Ünal¹,

Düzkalır²,

Kurt-Güney³

et al. 2016

Turk J Pediatr

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“…CD5 positivity gave strong evidence for the diagnosis of thymic carcinoma according to consensus by WHO classification (16) and the International Thymic Malignancy Interest Group (17). Previous reports have depended on the expression of CD5 to diagnose ectopic thymic (2,4,5), as well as CD117 in the case of intrapericardial ectopic thymic carcinoma (3). Moreover, CD5, CD117, MUC1, and GLUT1 can be used as specific markers to distinguish thymoma from thymic carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…Thymic carcinoma is a rare tumor, representing less than 1% of thymic malignancies. Ectopic thymic carcinoma is extremely rare, and has only been reported in a handful of case reports in the English literature (2)(3)(4)(5). Due to their unexpected location, ectopic thymic carcinomas are frequently misdiagnosed as one of the more common lesions seen at these sites.…”

Section: Introductionmentioning

confidence: 99%

Ectopic right parietal pleural thymic carcinoma: a rare case and review of the literature

et al. 2017

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Ectopic thymic carcinoma is extremely rare. We present a case of a 73-year-old male patient with ectopic right parietal pleural thymic carcinoma and performed a literature review. J Thorac Dis 2017;9(7):E609-E613 jtd.amegroups.com enhancement and a clear boundary adjacent to the ribs and intercostal tissue (Figure 1). An intrathoracic malignant tumor, most likely local malignant pleural mesothelioma or lung carcinoma with invasion into the parietal pleura, was suspected. CT images of the abdomen and skull showed no signs of lymph node enlargement or metastatic disease. An emission CT showed no signs of bone metastasis. Blood tests for tumor biomarkers were negative.The patient was scheduled for surgery. He underwent a video-assisted thoracoscopic surgery. A 7 cm × 4 cm × 3 cm tumor was found with a pedicle stemming from the anterior parietal pleura. It was tightly adhered to the right upper lung. No pleural effusion or nodules were found. There was no connection between the tumor and the mediastinum or the thymus. There was no obvious thymus tissue around the tumor. A totally extra-pleural tumor resection with partial right lung resection was performed. Fast frozen tissue specimen showed a poor differentiated squamous cell carcinoma. Hilar and mediastinal lymph nodes were dissected. Histological examination demonstrated infiltrative growth typical of carcinoma cells with a nestlike distribution that locally invaded the surface of the lung tissue but did not involve the subpleural tissue of the parietal pleura. The carcinoma cells were large and oval with a prominent nucleolus. A small amount of lymphocytes had also infiltrated among the carcinoma cells. Hyperplasia of collagen fibers existed between the cell nests. Immunohistochemical examination was positive for CD5, P63, and CK5/6, but negative for TIF-1, CD56, synaptophysin (Syn), mesothelial cell (MC), calretinin (CR), Wilm's tumor 1 protein (WT1), S-100, HMB-45, and Epstein-Barr virus RNA (EBER) (Figure 2). No lymph node metastases were found. These findings support a diagnosis of ectopic thymic squamous cell carcinoma. Cells that are CD5+ are specific for the diagnosis of primary thymic carcinoma (6). A final diagnosis of right parietal pleural ectopic thymic carcinoma was made.The patient was discharged on the 5 th postoperative day after an uneventful hospital course. Mediastinal radical radiotherapy (60 Gy) was performed postoperatively. The patient declined combined synchronous chemotherapy and thymectomy. After 17 months follow-up, the patient remained alive without any evidence of disease recurrence or metastasis. DiscussionThymic carcinomas are rare tumors (7) that usually occur in the anterior mediastinum. Rarely, however, ectopic thymic carcinoma can occur where the cancer is located outside of the mediastinum. Only 4 cases have been previously reported in the English literature. One case was a 49-year-old man who presented with cervical ectopic thymic squamous cell carcinoma with a microcarcinoma in his remnant mediastinal thymus (2). A...

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“…By contrast, reports of ectopic thymic carcinoma are very limited in view of its rarity, except for carcinoma showing thymus-like elements of the thyroid, so called CASTLE, whose pathogenesis is suspected to be a remnant of the branchial pouch from which the thyroid gland originates, and is thus not ectopic thymus tissue [2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

A Surgical Case of Heterotopic Thymic Carcinoma Coexisting With Hepatocellular Carcinoma

2015

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Although thymomas arising in ectopic regions other than the upper anterior mediastinum are well known, thymic carcinomas in ectopic locations are very rare. On the other hand, the therapeutic strategies for synchronous double primary cancers arising from different organs are still controversial. We have experienced a case of thymic carcinoma in an ectopic location with a coexisting hepatocellular carcinoma (HCC) for which management presented a number of difficulties. A 67-year-old man with HCC presented with a slow-growing nodular shadow in the left lower anterior mediastinum, i.e. the left cardiophrenic angle. During 7 years of intensive treatment for the HCC, the mediastinal nodule, which had been suspected clinically to be a lymph node metastasis from the HCC, grew to 4 cm in diameter. Surgical intervention for the mediastinal nodule was carried out for treatment and definitive diagnosis using a mediastinoscope inserted via a transverse xyphoid incision. Intraoperative pathological diagnosis from frozen sections of the mediastinal nodule revealed thymic carcinoma, and therefore the procedure was converted to thymothymectomy via a median sternotomy. Despite postoperative multimodality treatment, the patient died due to multifocal metastasis and pleuritis carcinomatosa from the thymic carcinoma within 7 months after the thymothymectomy. The unusual location of the thymic carcinoma in this case and the synchronous nature of the coexisting primary HCC resulted in delay of surgical resection for the former. More intensive observation and early intervention in the form of diagnostic or therapeutic resection should be performed for any mediastinal nodule that appears during the course of treatment for HCC.

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Ectopic Thymic Carcinoma in the Neck

Cited by 13 publications

References 6 publications

Aberrant cervical thymus and the role of ultrasonography: A case report

Aberrant cervical thymus and the role of ultrasonography: A case report

Ectopic right parietal pleural thymic carcinoma: a rare case and review of the literature

A Surgical Case of Heterotopic Thymic Carcinoma Coexisting With Hepatocellular Carcinoma

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