Two-year disease remission of an unresectable basaloid thymic carcinoma with second line chemotherapy drugs: report of a case

Abstract

Thymic carcinomas are extremely infrequent neoplasms (15% of all thymic epithelial tumors). Basaloid carcinoma is a peculiar tumor that represents no more than 2% of those infrequent thymic carcinomas. Surgical excision is the recommended treatment. As it's extremely rare, there is no evidence of the impact of different modalities of treatment. There are no reported cases that did not include surgery as part of their management. We herein present a case of an unresectable thymic basaloid carcinoma treated only with concurrent chemotherapy and radiotherapy that obtained a complete remission and free of disease after 2 years.

Basaloid Squamous Cell Carcinomas of the Thymus With Prominent B-Cell Lymphoid Hyperplasia

“…Several authors have documented unresectable basaloid carcinomas, others invasion into adjacent structures, such as pleura, pericardium, and lung, and some have reported metastatic disease to the liver. [13][14][15][16][17][18][19] It is important to note, that due to the unusual occurrence of basaloid carcinomas, most of the reported cases have been individual case reports. Although it has been recognized that some basaloid carcinomas were associated with a multilocular thymic cyst, 5 so far, the presence of B-cell lymphoid hyperplasia has not been reported as a feature of thymic carcinomas in general and more specifically in basaloid carcinomas.…”

“…Even though in the past, basaloid carcinoma has been grouped among the low-grade thymic carcinomas, there are reports of these tumors displaying more aggressive behavior. Several authors have documented unresectable basaloid carcinomas, others invasion into adjacent structures, such as pleura, pericardium, and lung, and some have reported metastatic disease to the liver 13–19 . It is important to note, that due to the unusual occurrence of basaloid carcinomas, most of the reported cases have been individual case reports.…”

Surgical management of locally invasive basaloid carcinoma of thymic gland

“…Our patient had at presentation a locally advanced tumor with pulmonary and phrenic nerve involvement but no clear evidence of extra-thoracic spread or involvement of other mediastinal structures. Given rarity of primary thymic basaloid carcinoma, the clinical benefits of any treatment modality remain unclear [ 2 , 3 ]. In almost all previously published cases, surgical excision has been the recommended treatment and has been performed in almost all cases [ 3 ].…”

“…Given rarity of primary thymic basaloid carcinoma, the clinical benefits of any treatment modality remain unclear [ 2 , 3 ]. In almost all previously published cases, surgical excision has been the recommended treatment and has been performed in almost all cases [ 3 ]. In our case, we extrapolated the treatment for thymic basaloid carcinoma from that for thymic carcinoma, an aggressive tumor with poorer prognosis and higher mortality than thymomas [ 6 ].…”

“…Thymic basaloid carcinoma is a rare thymic tumor variant that only a few cases have been reported in the literature [ 1 ]. In previous studies, evaluation of various treatment modalities used to treat patients with all types of thymic carcinomas did not yield any statistically significant correlations with survival [ 2 , 3 ]. We herein present a case of locally advanced thymic basaloid carcinoma treated by aggressive surgical management with en bloc resection of surrounding structures followed by adjuvant radiation therapy.…”