1
|
Luciano A, Pietroluongo E, Ottaviano M, Grieco A, Peddio A, De Placido P, Servetto A, Mascolo M, Varricchio S, Bianco R, Palmieri G, Giuliano M. Case report: Potential role of immunotherapy in thymic malignancies: a unique case of a durable and complete response upon an immune checkpoint inhibitor. Front Immunol 2024; 15:1423800. [PMID: 39026684 PMCID: PMC11255414 DOI: 10.3389/fimmu.2024.1423800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
Thymic epithelial tumors are rare malignancies with an incidence of 1.7 cases per million people per year. They pose significant management challenges due to their association with autoimmune disorders. In this case report, we present the 21-year history of a patient diagnosed with advanced B2/B3 thymoma and Good's syndrome. The patient achieved a complete and durable response after receiving only two cycles of the immune checkpoint inhibitor Nivolumab. However, this positive outcome was accompanied by the development of severe immune-related myocarditis complicated by reactivation of cytomegalovirus. Moreover, the patient developed a highly uncommon subdiaphragmatic pararectal dissemination of the thymic tumor, which is a condition rarely described in the literature. Despite the success in achieving complete and durable response with immune checkpoint inhibitors, the emergence of immune-related adverse events highlights the potential challenges associated with these treatments, emphasizing the need for careful monitoring and a comprehensive understanding of the intricate interplay between cancer, immune system dysregulations and immunotherapy.
Collapse
Affiliation(s)
- Angelo Luciano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Erica Pietroluongo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Margaret Ottaviano
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G. Pascale, Naples, Italy
| | - Angela Grieco
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Annarita Peddio
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pietro De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Alberto Servetto
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Unit of Pathology, University of Naples Federico II, Naples, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Unit of Pathology, University of Naples Federico II, Naples, Italy
| | - Roberto Bianco
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Giovannella Palmieri
- Regional Coordinating Center for Rare Tumors (CRCTR) of Campania Region at University Federico II, Naples, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| |
Collapse
|
2
|
Moura de Azevedo S, Baptista P, Pichel RC, Dias RR, Bertão M. A Rare Case of Mediastinal Mass: Thymoma and Thymic Tumor. Cureus 2023; 15:e40956. [PMID: 37503485 PMCID: PMC10369011 DOI: 10.7759/cureus.40956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/29/2023] Open
Abstract
Thymomas and thymic carcinomas are rare mediastinal neoplasms arising from thymic epithelial cells, and the presence of synchronous or metachronous primary thymic neoplasms in a single patient is an extremely rare event. Thymoma patients appear to have an inherent predisposition toward developing additional neoplasms. This additionally presents a diagnostic challenge, revealing the importance of multidisciplinary expertise to the management of these patients. This is a case report of a patient with a thymoma and thymic carcinoma, submitted to surgical resection and postoperative radiotherapy.
Collapse
Affiliation(s)
| | - Patrícia Baptista
- Internal Medicine, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Rita C Pichel
- Oncology, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Rita R Dias
- Internal Medicine, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Manuela Bertão
- Internal Medicine, Centro Hospitalar Universitário de Santo António, Porto, PRT
| |
Collapse
|
3
|
Daniel VC, Shilo K. Two Thymomas of Different Histological Subtypes Arising in a Giant Thymolipoma: Case Report and Review of the Literature. Int J Surg Pathol 2022:10668969221137523. [PMID: 36437637 DOI: 10.1177/10668969221137523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Thymolipoma is a rare benign tumor of the anterior mediastinum. Only a few reports describing thymoma arising within a thymolipoma have been documented in the literature. We report herein a detailed description of thymolipoma giving rise to 2 thymomas of different histological subtypes. A 74-year-old male with history of metastatic papillary thyroid carcinoma gradually developed 2 soft tissue nodules within a large right hemithorax fatty mass that was present for the past 20 years. Computed tomography (CT)-guided needle biopsy revealed one of the soft tissue nodules to be a thymoma, and the entire mass was surgically resected. Final pathological examination demonstrated the mass to be a thymolipoma containing a micronodular thymoma with lymphoid stroma as well as a WHO type B1 thymoma. No evidence of disease recurrence was seen at the time of his 7-year follow-up. This case documents a rare presentation of thymolipoma harboring 2 thymomas of different histological subtypes and highlights the need for early surgical resection of thymolipomas, as they may harbor malignant nodules.
Collapse
Affiliation(s)
- Vincent C Daniel
- Department of Cardiothoracic Surgery, OhioHealth Grant Medical Center, Columbus, OH, USA
| | - Konstantin Shilo
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| |
Collapse
|
4
|
Bin Saleem MY, Albandar MH, Alfaifi JA. Synchronous Colon and Breast Cancers: A Case Report of Multiple Primary Tumors. Cureus 2022; 14:e24798. [PMID: 35676989 PMCID: PMC9169435 DOI: 10.7759/cureus.24798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/09/2022] Open
Abstract
Multiple primary malignant tumors (MPMNs) are not rare entities. We report a case of a 50-year-old female who presented with left upper quadrant abdominal pain and GI bleeding. Initial assessment with CT scan revealed a mass originating from the descending colon. Colonoscopy was performed and a fungating partially obstructed mass at the left splenic flexure was detected. Histopathological examination of biopsy was consistent with mucinous adenocarcinoma. The staging CT scan of the chest and pelvis, followed by a mammogram reported a Synchronous breast mass. Core needle biopsy detected an invasive ducal carcinoma. In the multidisciplinary meeting, it was decided to perform the colon procedure first, followed by adjuvant chemotherapy, and then the breast procedure. The patient had an uneventful recovery after both procedures and was sent to the medical oncology department to continue with the treatment.
Collapse
|
5
|
Capion T, Hauerberg J, Broholm H, Muhic A. Multiple Extracranial Metastases from Primary Gliosarcoma in a Patient with Two Previous Different Primary Cancers. Case Rep Oncol Med 2019; 2019:7849616. [PMID: 31565453 PMCID: PMC6745105 DOI: 10.1155/2019/7849616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/26/2019] [Accepted: 08/08/2019] [Indexed: 01/15/2023] Open
Abstract
Gliosarcoma (GS) constitutes a minor fraction of primary glioblastoma (GBM), which is the most frequent malignant brain tumor in adults. Despite the fact that malignant gliomas are highly invasive, extracranial metastases are very rarely seen, and the mechanisms behind extracranial dissemination are still unclarified. We report a case of a 55-year-old male with a prior history of two distinct primary cancer types who, as a third independent type, developed GS with penetrating tumor growth to the skull and subcutaneous soft tissue via explosive spreading through a titanium net as well as extracranial metastases to the lumbar spine, paravertebral musculature, and most likely the right lung. The case illuminates the clinical challenge of diagnosing extracranial metastases from primary GBM and GS as these are still unexpected, especially in cases with possible competing diagnoses.
Collapse
Affiliation(s)
- T. Capion
- Department of Neurosurgery, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - J. Hauerberg
- Department of Neurosurgery, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - H. Broholm
- Department of Pathology, Center of Diagnostic Investigation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - A. Muhic
- Department of Oncology, The Finsen Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Yanagiya M, Matsumoto J, Kawahara T, Yamaguchi H, Nagayama K, Anraku M, Sato M, Nakajima J. Influence of Smoking and Histologic Subtype on Developing Extrathymic Malignancy in Thymoma Patients. Ann Thorac Surg 2018; 107:1532-1539. [PMID: 30576633 DOI: 10.1016/j.athoracsur.2018.11.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 11/07/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Patients with thymomas are at high risk of developing extrathymic malignancies. We investigated the impact of extrathymic malignancies on the prognosis of patients with thymoma who underwent surgery and the risk factors for postoperative extrathymic malignancies. METHODS A multicenter retrospective review of 252 patients who underwent surgical resection of thymomas from January 1977 to March 2016 was conducted. The exclusion criteria were recurrent thymoma, rare types of thymoma, and missing data. The overall number and incidence of extrathymic malignancies were calculated. Potential predictors of extrathymic malignancies were also evaluated. RESULTS Two hundred twenty-eight patients were analyzed. Fifty-five extrathymic malignancies were observed (23 postoperative, 8 synchronous, and 24 preoperative). Among the overall cohort, the incidence of extrathymic malignancies significantly increased the patients' risk of death (hazard ratio [HR], 4.02; 95% confidence interval [CI], 1.72 to 9.40; p < 0.01). Among patients aged less than 70 years, the incidence of extrathymic malignancies was an independent risk factor for death. The incidence of postoperative extrathymic malignancies was significantly higher in patients with indolent forms of thymoma (type A/AB/B1) than aggressive forms (type B2/B3) (p = 0.02). In the multivariate analysis, indolent forms of thymoma (type A/AB/B1) (HR, 4.03; 95% CI, 1.12 to 14.6, p = 0.03) and a history of ever having smoked (HR, 5.29; 95% CI, 1.30 to 21.6; p = 0.02) were significant risk factors for the cumulative incidence of postoperative extrathymic malignancies. CONCLUSIONS Extrathymic malignancies increased the risk of death in patients with thymomas. Indolent forms of thymoma and a history of ever having smoked were risk factors for postoperative extrathymic malignancies.
Collapse
Affiliation(s)
- Masahiro Yanagiya
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
| | - Jun Matsumoto
- Department of General Thoracic Surgery, NTT Medical Center, Tokyo, Japan
| | - Takuya Kawahara
- Biostatistics Division, Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Hirokazu Yamaguchi
- Department of General Thoracic Surgery, NTT Medical Center, Tokyo, Japan
| | - Kazuhiro Nagayama
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Masaki Anraku
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Masaaki Sato
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Jun Nakajima
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
8
|
Kumar V, Garg M, Goyal A, Chaudhary N, Soni P, Binod Chandra A. Changing pattern of secondary cancers among patients with malignant thymoma in the USA. Future Oncol 2018; 14:1943-1951. [PMID: 30081670 DOI: 10.2217/fon-2017-0626] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The risk of developing secondary cancers (SCs) among patients with malignant thymoma in the US has not been estimated in the more recent time period. Methods: We extracted demographic and treatment data from the SEER database to estimate the standardized incidence ratios (SIRs). Results: Of 1570 patients with thymoma 211 (13.4%) had SCs. The overall risk of developing SCs was higher among patients with thymoma (SIR: 1.54, 95% CI: 1.34-1.76). The SIRs for cancers of lung, esophagus, sigmoid colon, soft tissue and heart, kidney, NHL and leukemia was significantly higher as compared to the general US population. Conclusions: Patients with thymoma are at modestly elevated risk of developing SCs as compared to the general US population. Although the overall risk has not changed after 14 additional years of follow up, the distribution of SCs has significantly broadened, with increased diversity across type and anatomic location of SCs.
Collapse
Affiliation(s)
- Vivek Kumar
- Department of General Internal Medicine, Brigham & Women's Hospital, Boston, MA 02115, USA
| | - Mohit Garg
- Department of Anesthesia, Maimonides Medical Center, New York, NY 11219, USA
| | - Abhishek Goyal
- Department of General Internal Medicine, Brigham & Women's Hospital, Boston, MA 02115, USA
| | - Neha Chaudhary
- Department of Pediatrics, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Parita Soni
- Department of Pulmonary and Critical Care Medicine, Maimonides Medical Center, New York, NY 11219, USA
| | - Abhinav Binod Chandra
- Department of Medical Oncology, Yuma Regional Medical Center, Cancer Center Yuma, AZ 85364, USA
| |
Collapse
|
9
|
Naydenov E, Bussarsky V, Angelov K, Penkov M, Nachev S, Hadjidekova S, Toncheva D. Metachronous Development of Meningothelial Meningioma, Basal Cell Carcinoma, and Glioblastoma Multiforme in a Patient with Pancreatic Incidentaloma. Case Rep Oncol 2017; 10:1023-1028. [PMID: 29279708 PMCID: PMC5731176 DOI: 10.1159/000484404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 10/18/2017] [Indexed: 01/17/2023] Open
Abstract
We report the unique case of a 61-year-old male patient with known pancreatic incidentaloma who additionally developed 3 other histologically different tumors: left sphenoid wing meningothelial meningioma, basal cell carcinoma of the occiput, and right occipital lobe glioblastoma multiforme. The latter were totally removed with a favorable clinical outcome. The patient's family history was unremarkable, and no data on any previous head and neck irradiation were found.
Collapse
Affiliation(s)
- Emanuil Naydenov
- Department of Neurosurgery, University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - Venceslav Bussarsky
- Department of Neurosurgery, University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - Kostadin Angelov
- Department of General Surgery, University Hospital "Alexandrovska", Sofia, Bulgaria
| | - Marin Penkov
- Department of Radiology, University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - Sevdalin Nachev
- Laboratory of Neuropathology, University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | | | - Draga Toncheva
- Department of Medical Genetics, Medical University, Sofia, Bulgaria
| |
Collapse
|
10
|
Kamata T, Yoshida S, Wada H, Fujiwara T, Suzuki H, Nakajima T, Iwata T, Nakatani Y, Yoshino I. Extrathymic malignancies associated with thymoma: a forty-year experience at a single institution. Interact Cardiovasc Thorac Surg 2017; 24:576-581. [PMID: 28040768 DOI: 10.1093/icvts/ivw354] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 08/19/2016] [Indexed: 01/31/2023] Open
Abstract
Objectives Patients with thymoma are reported to have an increased risk for developing second malignancies. The aim of this study was to assess the incidence of second malignancies among patients with thymoma. We focused especially on the impact that lung cancer has on survival in these patients. Methods Three hundred and thirty-five patients who underwent surgery for thymoma in Chiba University Hospital from January 1971 to November 2012 were included in this study. Patient records were reviewed retrospectively for data on background, treatment, second malignancies and clinical outcome. Results Fourteen patients had a history of malignancy until the time of operation, with an additional 20 diagnosed simultaneously with the thymoma. Forty-three malignant lesions in 33 patients were found post-thymectomy. Lung cancer was diagnosed in 17 patients, far exceeding the expected number in the cohort, which was calculated according to Japanese national data. The median survival time of the thymoma patients who had lung cancer at the time of surgery was 5.8 years. The survival of patients with thymoma and lung cancer was poor in comparison with that of others. Conclusions Secondary lung cancer is frequently found in thymoma patients and could be one of the factors limiting survival. We recommend an annual computed tomographic scan of the thorax to detect not only recurrent thymoma but also lung cancer at an early stage in order to improve the survival of these patients.
Collapse
Affiliation(s)
- Toshiko Kamata
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shigetoshi Yoshida
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hironobu Wada
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Taiki Fujiwara
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hidemi Suzuki
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takahiro Nakajima
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takekazu Iwata
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yukio Nakatani
- Department of Diagnostic Pathology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| |
Collapse
|
11
|
Athanasiou E, Michalopoulou-Manoloutsiou E, Bobos M, Hatzibougias DI, Zarogoulidis P, Katsikogiannis N, Sarika E, Karapantzos I, Barbetakis N, Paliouras D, Chatzinikolaou F, Charalampidis C, Kougioumtzi I, Kolettas A, Bakas A, Tzelepi K, Kalaitzis E, Tsakiridis K. Coincidence of thymoma and breast cancer and in a 56-year-old female patient. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:446. [PMID: 27999780 DOI: 10.21037/atm.2016.11.34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We present a case of a 56-year-old female, with a familial history of breast, lung and brain cancer, which revealed a breast tumor, located in the upper outer quadrant of the left breast. During the routinely staging examinations, a 15 cm intrathoracic tumor was found in the upper left mediastinum, penetrating the pericardium and a smaller tumor, in the left side of parietal pleura. Core biopsies from both lesions, revealed a lobular carcinoma of the breast classic type, grade II (e-cadherin-, ER+, PR+, Her-2-, Ki-67 10%) and a B3 thymoma (CK19+, CD5+) penetrating the pericardium and the left lung. A synchronous removal of both tumors was scheduled, including median sternotomy and left intrapericardial pneumonectomy, followed by a modified radical left mastectomy and a sentinel lymph node biopsy. The postoperative course was uneventful. This case advocates that thymoma patients appear to have a predisposition towards developing additional neoplasms, as breast carcinoma. Clinicians should be aware of the increased incidence of extrathymic cancers, occurring in thymoma patients.
Collapse
Affiliation(s)
| | | | | | | | - Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolos Katsikogiannis
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Eirini Sarika
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ilias Karapantzos
- Ear, Nose and Throat Department, "St. Luke's", Private Hospital, Panorama, Thessaloniki, Greece
| | - Nikolaos Barbetakis
- Thoracic Surgery Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece
| | - Dimitrios Paliouras
- Thoracic Surgery Department, "Theagenio" Cancer Hospital, Thessaloniki, Greece
| | | | | | - Ioanna Kougioumtzi
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | | | | | | | | |
Collapse
|
12
|
Song Z, Yu X, Zhang Y. Rare frequency of gene variation and survival analysis in thymic epithelial tumors. Onco Targets Ther 2016; 9:6337-6342. [PMID: 27789964 PMCID: PMC5072509 DOI: 10.2147/ott.s108749] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective Thymic epithelial tumor (TET) is a rare mediastinal neoplasm and little is known about its genetic variability and prognostic factors. This study investigated the genetic variability and prognostic factors of TET. Patients and methods We sequenced 22 cancer-related hotspot genes in TET tissues and matched normal tissues using Ampliseq Ion Torrent next-generation technology. Overall survival was evaluated using Kaplan–Meier methods and compared with log-rank tests. Results A histological analysis of 52 patients with a median age of 52 years showed 15 patients (28.8%) with thymic carcinoma, five with type A thymoma (9.6%), eight with type AB (15.4%), six with type B1 (11.5%), nine with type B2 (17.3%), and nine with type B3 thymoma (17.3%). Three gene mutations were identified, including two with PIK3CA mutation and one with EGFR mutation. The three patients with mutant genes included two cases of thymoma (one with EGFR and the other with PIK3CA mutation) in addition to a case of thymic carcinoma (PIK3CA mutation). The 5-year survival rates were 77.7% in all patients. The 5-year survival rates were 93.3%, 90.0%, 76.9%, and 22.9% corresponding to Masaoka stages I, II, III, and IV (P<0.001). The 5-year survival rates were 100%, 100%, 83.3%, 88.9%, 65.6%, and 60.9% in the histological subtypes of A, AB, B1, B2, and B3 thymomas, and thymic carcinoma, respectively (P=0.012). Conclusion Hotspot gene mutations are rare in TET. PIK3CA and EGFR mutations represent candidate driver genes and treatment targets in TET. Masaoka stage and histological subtypes predict the survival of TET.
Collapse
Affiliation(s)
- Zhengbo Song
- Department of Medical Oncology, Zhejiang Cancer Hospital; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Province, Hangzhou, People's Republic of China
| | - Xinmin Yu
- Department of Medical Oncology, Zhejiang Cancer Hospital; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Province, Hangzhou, People's Republic of China
| | - Yiping Zhang
- Department of Medical Oncology, Zhejiang Cancer Hospital; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Province, Hangzhou, People's Republic of China
| |
Collapse
|
13
|
Lee M, Choi SJ, Yoon YH, Kim JT, Baek WK, Kim YS. Metastatic Thymic Adenocarcinoma from Colorectal Cancer. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2015; 48:447-51. [PMID: 26665119 PMCID: PMC4672987 DOI: 10.5090/kjtcs.2015.48.6.447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 10/17/2015] [Accepted: 10/19/2015] [Indexed: 02/02/2023]
Abstract
This report describes the case of a 57-year-old man with an anterior mediastinal tumor. Four years previously, he underwent laparoscopic anterior resection for sigmoid colon cancer. Thirty months after that procedure, bilateral pulmonary metastasectomy was performed. Twelve months later, follow-up computed tomography revealed a 1-cm pulmonary nodule on the upper lobe of the right lung and a solid mass on the anterior mediastinum, and the patient was also observed to have an elevated serum carcinoembryonic antigen (CEA) level. Repeated pulmonary nodule resection and total thymectomy were performed. Immunohistochemical staining of the anterior mediastinal tumor revealed adenocarcinoma, and his serum CEA level returned to normal after the operation. These findings strongly suggested metastatic thymic adenocarcinoma from a colorectal cancer.
Collapse
Affiliation(s)
- Mina Lee
- Department of Thoracic and Cardiovascular Surgery, Inha University Hospital
| | - Suk Jin Choi
- Department of Pathology, Inha University Hospital
| | - Yong Han Yoon
- Department of Thoracic and Cardiovascular Surgery, Inha University Hospital
| | - Joung-Taek Kim
- Department of Thoracic and Cardiovascular Surgery, Inha University Hospital
| | - Wan Ki Baek
- Department of Thoracic and Cardiovascular Surgery, Inha University Hospital
| | - Young Sam Kim
- Department of Thoracic and Cardiovascular Surgery, Inha University Hospital
| |
Collapse
|
14
|
Linhares P, Martinho O, Carvalho B, Castro L, Lopes JM, Vaz R, Reis RM. Analysis of a synchronous gliosarcoma and meningioma with long survival: A case report and review of the literature. Surg Neurol Int 2014; 4:151. [PMID: 24381794 PMCID: PMC3872647 DOI: 10.4103/2152-7806.122229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/03/2013] [Indexed: 12/15/2022] Open
Abstract
Background: The simultaneous occurrence of multiple intracranial neoplasms has been reported, especially in genetic familial syndromes and after cranial irradiation. In the absence of these etiologic factors, some reports showed simultaneous occurrence of glioblastoma and meningioma but the association between gliosarcoma and meningioma is unknown. Case Description: We report a case of a 51-year-old woman with synchronous gliosarcoma and meningioma in whom extensive immunohistochemical characterization and molecular profile was performed. The gliosarcoma recurred 21 months after the first resection, reaching 3 years of overall survival. A molecular characterization of all three lesions was performed. None of the lesions showed the presence of mutations in TP53 and BRAF genes. MGMT analysis showed the presence of loss of expression associated with promoter hypermethylation in both gliosarcoma lesions. EGFR overexpression and gene amplification was found only in the recurrent gliosarcoma. Conclusion: The immunohistochemistry and molecular data of this unique case, suggest the distinct clonal origin of meningioma and gliosarcoma lesions, and the association of MGMT methylation with the presumable favorable prognosis observed.
Collapse
Affiliation(s)
- Paulo Linhares
- Department of Neurosurgery, Hospital S. João, Porto, Portugal ; Medical Faculty of Porto University, Porto, Portugal
| | - Olga Martinho
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal ; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Bruno Carvalho
- Department of Neurosurgery, Hospital S. João, Porto, Portugal ; Medical Faculty of Porto University, Porto, Portugal
| | - Lígia Castro
- Department of Pathology, Hospital S. João, Porto, Portugal
| | - José Manuel Lopes
- Department of Pathology, Hospital S. João, Porto, Portugal ; Medical Faculty of Porto University, Porto, Portugal ; Medical Faculty of Porto University, IPATIMUP, Porto, Portugal
| | - Rui Vaz
- Department of Neurosurgery, Hospital S. João, Porto, Portugal ; Medical Faculty of Porto University, Porto, Portugal
| | - Rui Manuel Reis
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal ; Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, S. Paulo, Brazil ; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| |
Collapse
|
15
|
Fraser CR, Rios C, Kaya B. Composite Lymphocyte-Rich Thymoma and Peripheral T-Cell Lymphoma Not Otherwise Specified: Case Report and Literature Review. Lab Med 2012. [DOI: 10.1309/lmnzi133obtxqewq] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
16
|
Limmer KK, Kernstine KH. Minimally Invasive and Robotic-Assisted Thymus Resection. Thorac Surg Clin 2011; 21:69-83, vii. [DOI: 10.1016/j.thorsurg.2010.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
17
|
Woo KJ, Kim YK, Kim KU, Uh ST, Kim DW, Hwang JH, Kim YH, Park CS. A Case of Pleural Metastasis 6 Years after Complete Surgical Resection of Invasive Thymoma. Tuberc Respir Dis (Seoul) 2011. [DOI: 10.4046/trd.2011.70.1.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kwang Jin Woo
- Department of Respiratory and Allergy Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yang Ki Kim
- Department of Respiratory and Allergy Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Ki Up Kim
- Department of Respiratory and Allergy Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Soo-Taek Uh
- Department of Respiratory and Allergy Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Dong Won Kim
- Department of Pathology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jung-Hwa Hwang
- Department of, Diagnostic Radioloy, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yong Hoon Kim
- Department of Respiratory and Allergy Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Choon Sik Park
- Department of Respiratory and Allergy Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| |
Collapse
|
18
|
Yen YT, Lai WW, Wu MH, Lin MY, Chang JM, Hsu IL, Tseng YL. Thymic Neuroendocrine Carcinoma and Thymoma Are Both Associated With Increased Risk of Extrathymic Malignancy: A 20-Year Review of a Single Institution. Ann Thorac Surg 2011; 91:219-25. [DOI: 10.1016/j.athoracsur.2010.09.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Revised: 09/08/2010] [Accepted: 09/09/2010] [Indexed: 12/13/2022]
|
19
|
Zubaidi A. Multiple primary cancers of the colon, rectum, and the thyroid gland. Saudi J Gastroenterol 2008; 14:202-5. [PMID: 19568539 PMCID: PMC2702935 DOI: 10.4103/1319-3767.43277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Accepted: 04/06/2008] [Indexed: 12/02/2022] Open
Abstract
The major concern in the case of cancer, whether one or in worse case more than one, is the extent of treatment required and the prognosis. This article reports three cases with two cancers: colorectal cancer and thyroid cancer, in the same patient at the same time. It also discusses the related clinical presentation and management of the cancers, and a review of literature has been presented.
Collapse
Affiliation(s)
- Ahmad Zubaidi
- Department of Surgery, King Khalid University Hospital, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.
| |
Collapse
|