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Ose N, Kawagishi S, Funaki S, Kanou T, Fukui E, Kimura K, Minami M, Shintani Y. Thymic Lymphoepithelial Carcinoma Associated with Epstein-Barr Virus: Experiences and Literature Review. Cancers (Basel) 2021; 13:4794. [PMID: 34638279 PMCID: PMC8507618 DOI: 10.3390/cancers13194794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/07/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022] Open
Abstract
Thymic lymphoepithelial carcinoma (TLEC) is a primary thymic carcinoma that accounts for about 14% of all thymic epithelial tumors and is classified into 14 types. The histological morphology is similar to lymphoepithelioma, a type of undifferentiated nasopharyngeal carcinoma. It has been reported that squamous carcinoma accounts for approximately 80% of thymic carcinoma, followed by TLEC, which accounts for 6%. TLEC has been reported to be associated with Epstein-Barr virus (EBV), with EBV infection in TLEC tumor cells first noted by Lyvraz et al. in 1985. Tumors shown to be EBV-positive are classified as TLEC if lymphoplasmacytic infiltration is lacking. However, only about 50% of the cases are positive for EBV, which is lower compared to nasopharyngeal lymphoepithelioma. Instances of EBV infection in other types of thymic epithelial tumor have been reported at lower rates, which suggests that EBV infection may have an important influence on the carcinogenesis of TLEC, though the etiology is unknown. TLEC is a highly malignant tumor with poor prognosis, as affected patients have a median survival time of 22 months, according to 58 cases from the literature, while the 5-year survival rate is 34.4%. Presently, prognosis is not considered to be affected by the presence or absence of EBV positivity.
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Affiliation(s)
- Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Sachi Kawagishi
- Department of General Thoracic Surgery, Osaka International Cancer Institute, Chuo-ku, Osaka-shi 541-8567, Osaka, Japan;
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
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Kawagishi S, Ose N, Minami M, Funaki S, Kanou T, Kimura K, Taniguchi S, Morii E, Shintani Y. Total thymectomy for thymic lymphoepithelioma-like carcinoma-report of two cases. Surg Case Rep 2019; 5:158. [PMID: 31655916 PMCID: PMC6815289 DOI: 10.1186/s40792-019-0706-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/11/2019] [Indexed: 12/15/2022] Open
Abstract
Background Thymic carcinoma has been classified into 12 subtypes, thymic lymphoepithelioma-like carcinoma (LELC) is a type of them, and has a pathological organization similar to that of lymphoepithelioma, an undifferentiated type of nasopharyngeal carcinoma. According to a report from the International Thymic Malignancy Interest Group (ITMIG), thymic LELC is a rare tumor and accounts for 6% of all thymic carcinoma cases. We report two cases of surgical resection for thymic LELC and perform a search of other reports of thymic LELC, and clinical manifestations and follow-up data thus obtained are summarized. Case presentation Two patients underwent surgical resection for thymic LELC. In both, tumors were detected in the anterior mediastinum and a total thymectomy was performed. Each was diagnosed with thymic LELC and classified in accordance with the Masaoka staging system as modified stage II. In recent examinations, one patient was doing well after undergoing total resection, whereas early recurrence of distant lymph node metastasis was noted in the other at 5 months after the total resection procedure and died thereafter from a different disease. Conclusion We report two cases of surgical resection for thymic LELC. A successful total resection may positively affect prognosis: thus, long-term follow-up examinations must be performed.
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Affiliation(s)
- Sachi Kawagishi
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2(L5), Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2(L5), Yamadaoka, Suita-shi, Osaka, 565-0871, Japan. .,Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0971, Japan.
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2(L5), Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2(L5), Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2(L5), Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Kenji Kimura
- Department of Pathology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Seiji Taniguchi
- Department of Pathology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2(L5), Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
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Maruyama N, Sasaki T, Arasaki A, Matsuzaki A, Nakasone T, Teruya T, Matayoshi A, Maruyama T, Karube K, Fujita J, Yoshimi N, Kuniyoshi Y, Nishihara K. Thymoma appearing 9 years after the resection of squamous cell carcinoma of the lip: A case report of triple primary tumors and literature review. Oncol Lett 2019; 18:2777-2788. [PMID: 31452756 PMCID: PMC6704295 DOI: 10.3892/ol.2019.10675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 04/09/2019] [Indexed: 11/06/2022] Open
Abstract
The occurrence of second primary tumor (SPT)following malignancy treatment is common. In patients with head and neck (H&N) cancer, SPTs principally occur in the H&N region, lungs or esophagus. Therefore, patient follow-up after cancer treatment is important in order to detect recurrence, metastasis and new primary tumors. However, no standard guidelines on lifelong follow-up imaging are available. Herein, we report a patient who presented with three metachronous primary tumors-squamous cell carcinoma (SCC) of the tongue, SCC of the lip and type A thymoma. The third tumor was incidentally detected during follow-up using contrast-enhanced computed tomography (CT) 9 years following resection of the second tumor. To the best of our knowledge, this specific combination of metachronous tumors has not yet been reported. Based on the literature review, we observed that thymoma occurs following H&N cancer treatment. Therefore, to ensure that the presence of subsequent thymomas is not overlooked, we suggest regular lifelong follow-up using contrast-enhanced CT in patients who had previously been diagnosed with H&N cancer. The literature review revealed that thymomas occur in patients with H&N cancer and should be detected at the earliest convenience.
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Affiliation(s)
- Nobuyuki Maruyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Takanobu Sasaki
- Department of Thoracic and Cardiovascular Surgery, University Hospital of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Miyagi 983-8512, Japan
| | - Akira Arasaki
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Akiko Matsuzaki
- Department of Pathology, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Toshiyuki Nakasone
- Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Takao Teruya
- Department of Thoracic and Cardiovascular Surgery, University Hospital of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Akira Matayoshi
- Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Tessho Maruyama
- Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Molecular Microbiology Group, Tropical Biosphere Research Center, University of the Ryukyus, Nishihara, Okinawa 903-0213, Japan
| | - Kennosuke Karube
- Department of Pathology and Cell Biology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Jiro Fujita
- Department of Infectious Diseases, Respiratory, and Digestive Medicine (The First Department of Internal Medicine), University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Naoki Yoshimi
- Department of Pathology, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Yukio Kuniyoshi
- Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Kazuhide Nishihara
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
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Epstein-Barr virus (EBV) associated lymphoepithelioma-like thymic carcinoma associated with paraneoplastic syndrome of polymyositis: a rare tumor with rare association. Clin Nucl Med 2010; 34:686-8. [PMID: 19893401 DOI: 10.1097/rlu.0b013e3181b53f5a] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Thymic carcinomas are rare neoplasms representing less than 1% of all thymic malignancies arising from thymic epithelium. Lymphoepithelioma-like thymic carcinoma is a high grade neoplasm with aggressive features and frequent metastasis. Association of lymphoepithelioma-like thymic carcinomas with Epstein-Barr virus was observed in several previously reported case reports. Paraneoplastic syndromes have been reported with lymphoepithelioma-like thymic carcinoma. We report a case of rare association of paraneoplastic syndrome of polymyositis with lymphoepithelioma-like thymic carcinoma. The case highlights generalized increase in fluoro-deoxy-glucose uptake in the skeletal muscles indicating biopsy proven polymyositis-a paraneoplastic syndrome.
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