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Sorin V, Kirshenboim Z, Klug M, Ahuja J, Marom EM. The Ninth Edition TNM Staging Classification for Thymic Epithelial Tumors. Semin Ultrasound CT MR 2024:S0887-2171(24)00046-5. [PMID: 39069277 DOI: 10.1053/j.sult.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Staging classification is essential in cancer management and is based on three components: tumor extent (T), lymph node involvement (N), and distant metastatic disease (M). For thymic epithelial malignancies, clinical Tumour, Node, Metastasis (cTNM) staging is primarily determined by imaging, making radiologists integral to clinical practice, treatment decisions, and maintaining the quality of staging databases. The ninth edition of the TNM classification for thymic epithelial tumors will be implemented in January 2025. This review outlines the definitions for the TNM categories in the updated edition, provides examples, and elaborates on the radiologist's role and imaging considerations.
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Affiliation(s)
- Vera Sorin
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Affiliated to the Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | | | - Maximiliano Klug
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Affiliated to the Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jitesh Ahuja
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Edith M Marom
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Affiliated to the Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Strange CD, Truong MT, Ahuja J, Strange TA, Patel S, Marom EM. Imaging evaluation of thymic tumors. MEDIASTINUM (HONG KONG, CHINA) 2023; 7:28. [PMID: 37701637 PMCID: PMC10493619 DOI: 10.21037/med-22-58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/19/2023] [Indexed: 09/14/2023]
Abstract
An integral part of managing patients with thymoma and thymic carcinoma is imaging. At diagnosis and staging, imaging helps demonstrate the extent of local invasion and distant metastases which allows the proper stratification of patients for therapy. For decades, the predominant staging system for thymic tumors was the Masaoka-Koga staging system. More recently, however, the International Association for the Study of Lung Cancer, the International Thymic Malignancies Interest Group (ITMIG), the European Society of Thoracic Surgeons, the Chinese Alliance for Research on Thymomas, and the Japanese Association of Research on Thymus partnered together to develop a tumor-node-metastasis (TNM) staging system specifically for thymic tumors based on a retrospective database of nearly 10,000 patients. The TNM 8th edition defines specific criteria for thymic tumors. Imaging also serves to assess treatment response and detect recurrent disease after various treatment modalities. The Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 is currently used to assess response to treatment. ITMIG recommends certain modifications to RECIST version 1.1, however, in thymic tumors due to unique patterns of spread. While there is often overlap, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) characteristics can help differentiate thymoma and thymic carcinoma, with newer CT and MRI techniques under evaluation showing encouraging potential.
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Affiliation(s)
- Chad D. Strange
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mylene T. Truong
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jitesh Ahuja
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Smita Patel
- Division of Cardiothoracic Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Edith M. Marom
- Department of Diagnostic Radiology, Chaim Sheba Medical Center, Affiliated with the Tel Aviv University, Tel Hashomer, Israel
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Covington MF, Koppula BR, Fine GC, Salem AE, Wiggins RH, Hoffman JM, Morton KA. PET-CT in Clinical Adult Oncology: II. Primary Thoracic and Breast Malignancies. Cancers (Basel) 2022; 14:cancers14112689. [PMID: 35681669 PMCID: PMC9179296 DOI: 10.3390/cancers14112689] [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] [Received: 04/27/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Positron emission tomography (PET), typically combined with computed tomography (CT), has become a critical advanced imaging technique in oncology. With PET-CT, a radioactive molecule (radiotracer) is injected in the bloodstream and localizes to sites of tumor because of specific cellular features of the tumor that accumulate the targeting radiotracer. The CT scan, performed at the same time, provides information to facilitate assessment of the amount of radioactivity from deep or dense structures, and to provide detailed anatomic information. PET-CT has a variety of applications in oncology, including staging, therapeutic response assessment, restaging, and surveillance. This series of six review articles provides an overview of the value, applications, and imaging and interpretive strategies of PET-CT in the more common adult malignancies. The second article in this series addresses the use of PET-CT in breast cancer and other primary thoracic malignancies. Abstract Positron emission tomography combined with x-ray computed tomography (PET-CT) is an advanced imaging modality with oncologic applications that include staging, therapy assessment, restaging, and surveillance. This six-part series of review articles provides practical information to providers and imaging professionals regarding the best use of PET-CT for the more common adult malignancies. The second article of this series addresses primary thoracic malignancy and breast cancer. For primary thoracic malignancy, the focus will be on lung cancer, malignant pleural mesothelioma, thymoma, and thymic carcinoma, with an emphasis on the use of FDG PET-CT. For breast cancer, the various histologic subtypes will be addressed, and will include 18F fluorodeoxyglucose (FDG), recently Food and Drug Administration (FDA)-approved 18F-fluoroestradiol (FES), and 18F sodium fluoride (NaF). The pitfalls and nuances of PET-CT in breast and primary thoracic malignancies and the imaging features that distinguish between subcategories of these tumors are addressed. This review will serve as a resource for the appropriate roles and limitations of PET-CT in the clinical management of patients with breast and primary thoracic malignancies for healthcare professionals caring for adult patients with these cancers. It also serves as a practical guide for imaging providers, including radiologists, nuclear medicine physicians, and their trainees.
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Affiliation(s)
- Matthew F. Covington
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Bhasker R. Koppula
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Gabriel C. Fine
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Ahmed Ebada Salem
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
- Department of Radiodiagnosis and Intervention, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt
| | - Richard H. Wiggins
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - John M. Hoffman
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Kathryn A. Morton
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
- Intermountain Healthcare Hospitals, Summit Physician Specialists, Murray, UT 84123, USA
- Correspondence: ; Tel.: +1-801-581-7553
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Tosi D, Damarco F, Franzi S, Mohamed S, Palleschi A, Mendogni P. Outcomes of extended surgical resections for locally advanced thymic malignancies: a narrative review. Gland Surg 2022; 11:611-621. [PMID: 35402207 PMCID: PMC8984987 DOI: 10.21037/gs-21-642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/14/2021] [Indexed: 08/31/2023]
Abstract
BACKGROUND AND OBJECTIVE Thymic malignancies represent the most common anterior mediastinal neoplasms, as well as rare and challenging tumors. Surgery is the cornerstone in the treatment of thymic malignancies, although a multidisciplinary approach is mandatory, for both, locally advanced or metastatic disease. In our narrative review, we explored the recent literature to investigate clinical and radiological assessment, multimodality approach and outcomes of locally advanced thymic tumors. More than one-third of patients affected by an anterior mediastinal mass are asymptomatic at diagnosis. In case of locally advanced thymoma, symptoms are related to compression or invasion of adjacent structures, such as the superior vena cava (SVC), innominate veins and pericardium. Paraneoplastic syndromes, such as myasthenia gravis (MG), are related to release of antibodies, hormones and cytokines. METHODS Diagnostic methods must be chosen accurately to avoid unnecessary surgical resections, to define the best strategy of care, and to plan the surgical strategy. Therefore, each case must be evaluated in a multidisciplinary context, where surgery plays an essential role. KEY CONTENT AND FINDINGS In this narrative review, we describe indications and surgical techniques for the treatment of locally advanced thymoma; focusing on oncological outcomes after different approaches. CONCLUSIONS In conclusion, aggressive surgery is always indicated, when possible, and when a complete resection can be planned, yet, the multidisciplinary approach is mandatory, in case of both locally or metastatic advanced disease.
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Affiliation(s)
- Davide Tosi
- Thoracic Surgery and Lung Transplantation Unit, IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Damarco
- Thoracic Surgery and Lung Transplantation Unit, IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Franzi
- Thoracic Surgery and Lung Transplantation Unit, IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Alessandro Palleschi
- Thoracic Surgery and Lung Transplantation Unit, IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan, Milan, Italy
| | - Paolo Mendogni
- Thoracic Surgery and Lung Transplantation Unit, IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Strange CD, Ahuja J, Shroff GS, Truong MT, Marom EM. Imaging Evaluation of Thymoma and Thymic Carcinoma. Front Oncol 2022; 11:810419. [PMID: 35047412 PMCID: PMC8762255 DOI: 10.3389/fonc.2021.810419] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/09/2021] [Indexed: 01/28/2023] Open
Abstract
Imaging is integral in the management of patients with thymoma and thymic carcinoma. At initial diagnosis and staging, imaging provides the clinical extent of local invasion as well as distant metastases to stratify patients for therapy and to determine prognosis. Following various modalities of therapy, imaging serves to assess treatment response and detect recurrent disease. While imaging findings overlap, a variety of CT, MRI, and PET/CT characteristics can help differentiate thymoma and thymic carcinoma, with new CT and MRI techniques currently under evaluation showing potential.
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Affiliation(s)
- Chad D Strange
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jitesh Ahuja
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Girish S Shroff
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Mylene T Truong
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Edith M Marom
- Department of Diagnostic Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
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Xu H, Fan F, Gong Y, Jing X, Lin X, Wang H, Lin F, Li Z. Diagnostic Challenges in Fine-Needle Aspiration Cytology of Mediastinal Tumors and Lesions. Arch Pathol Lab Med 2021; 146:960-974. [PMID: 34402861 DOI: 10.5858/arpa.2021-0108-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Mediastinal tumors/lesions are frequently encountered in daily cytopathology practice. These lesions are accessible through endoscopic/endobronchial ultrasound-guided or computed tomography-guided fine-needle aspiration cytology and represent a wide range of primary and metastatic tumors. This often poses diagnostic challenges because of the complexity of the mediastinal anatomic structures. Tumors metastatic to mediastinal lymph nodes represent the most common mediastinal lesions and must be differentiated from primary lesions. OBJECTIVE.— To provide an updated review on the fine-needle aspiration cytology of mediastinal tumors/lesions, with an emphasis on diagnostic challenges. This review encompasses thymic epithelial neoplasms, mediastinal lymphoproliferative disorders, germ cell tumors, neuroendocrine tumors, soft tissue tumors, and metastatic tumors. Differential diagnoses; useful ancillary studies, including targeted immunohistochemical panels; and diagnostic pitfalls are discussed. DATA SOURCES.— Data were gathered from a PubMed search of peer-reviewed literature on mediastinal tumors. Data were also collected from the authors' own practices. CONCLUSIONS.— Fine-needle aspiration cytology plays a vital role in evaluation of mediastinal lesions. Being familiar with the clinical and cytomorphologic features of these lesions, appropriately triaging the diagnostic material for ancillary testing, and correlating with radiologic findings are important in arriving at correct diagnoses and guiding management.
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Affiliation(s)
- Huihong Xu
- From the Department of Pathology, Boston VA Healthcare System, Boston University, Boston, Massachusetts (Xu)
| | - Fang Fan
- the Department of Pathology, University of Kansas Medical Center, Kansas City (Fan)
| | - Yun Gong
- the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Gong)
| | - Xin Jing
- the Department of Pathology, University of Michigan, Ann Arbor (Jing)
| | - Xiaoqi Lin
- the Department of Pathology, Northwestern University, Chicago, Illinois (X. Lin)
| | - He Wang
- the Department of Pathology, Yale University, New Haven, Connecticut (Wang)
| | - Fan Lin
- the Department of Pathology, Geisinger Medical Center, Danville, Pennsylvania (F. Lin)
| | - Zaibo Li
- the Department of Pathology, The Ohio State University Wexner Medical Center, Columbus (Li)
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Gentili F, Monteleone I, Mazzei FG, Luzzi L, Del Roscio D, Guerrini S, Volterrani L, Mazzei MA. Advancement in Diagnostic Imaging of Thymic Tumors. Cancers (Basel) 2021; 13:cancers13143599. [PMID: 34298812 PMCID: PMC8303549 DOI: 10.3390/cancers13143599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 01/25/2023] Open
Abstract
Simple Summary Diagnostic imaging is pivotal for the diagnosis and staging of thymic tumors. It is important to distinguish thymoma and other tumor histotypes amenable to surgery from lymphoma. Furthermore, in cases of thymoma, it is necessary to differentiate between early and advanced disease before surgery since patients with locally advanced tumors require neoadjuvant chemotherapy for improving survival. This review aims to provide to radiologists a full spectrum of findings of thymic neoplasms using traditional and innovative imaging modalities. Abstract Thymic tumors are rare neoplasms even if they are the most common primary neoplasm of the anterior mediastinum. In the era of advanced imaging modalities, such as functional MRI, dual-energy CT, perfusion CT and radiomics, it is possible to improve characterization of thymic epithelial tumors and other mediastinal tumors, assessment of tumor invasion into adjacent structures and detection of secondary lymph nodes and metastases. This review aims to illustrate the actual state of the art in diagnostic imaging of thymic lesions, describing imaging findings of thymoma and differential diagnosis.
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Affiliation(s)
- Francesco Gentili
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (F.G.M.); (S.G.)
- Correspondence:
| | - Ilaria Monteleone
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (I.M.); (D.D.R.); (L.V.); (M.A.M.)
| | - Francesco Giuseppe Mazzei
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (F.G.M.); (S.G.)
| | - Luca Luzzi
- Thoracic Surgery Unit, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy;
| | - Davide Del Roscio
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (I.M.); (D.D.R.); (L.V.); (M.A.M.)
| | - Susanna Guerrini
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (F.G.M.); (S.G.)
| | - Luca Volterrani
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (I.M.); (D.D.R.); (L.V.); (M.A.M.)
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (I.M.); (D.D.R.); (L.V.); (M.A.M.)
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Guleria P, Parshad R, Malik PS, Ray R, Pandey RM, Jain D. Histotyping of Indian thymomas: A clinicopathologic study from north India. Indian J Med Res 2020; 150:153-160. [PMID: 31670270 PMCID: PMC6829775 DOI: 10.4103/ijmr.ijmr_530_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background & objectives: Thymomas are rare, but most common anterior mediastinal lesions. The histomorphologic spectrum of thymic epithelial tumours (TETs) in Indian population has not been explored in depth. This study was aimed to assess the histomorphology of TETs in the Indian patients and correlate clinical parameters with pathological features. Methods: It was a retrospective study conducted in a tertiary referral hospital in north India. All morphologically confirmed cases of TETs since 2009 were included. Clinical details and histology slides were reviewed using the Modified Masaoka-Koga staging system and WHO 2015 classification. Clinicopathological correlation and survival analysis were done. A comparative review from other published Indian studies was performed. Results: A total of 219 cases of TETs (138 resections and 81 biopsies) were identified. The most common histomorphologic type was B2, and the most frequent stage was I. Types A/AB were common in older age (P<0.01). Clinically, higher stage tumours were found mostly in men (P<0.01), and these were Type B thymomas (P<0.01). Myasthenia gravis was more common in women (P<0.02) and in lower stages (P<0.05). Survival analysis revealed significant association between recurrence and tumour stage. Although thymic carcinoma was diagnosed on biopsy, no resectable case was identified. Interpretation & conclusions: Our findings showed that the thymomas in Indian patients were most commonly Stage I tumours of B2 and AB histotypes. Resected thymic carcinomas were conspicuously absent in our study. More studies need to be done to establish the frequency and biology of TETs from India.
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Affiliation(s)
- Prerna Guleria
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajinder Parshad
- Department of Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhat Singh Malik
- Department of Medical Oncology, B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Ruma Ray
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Berman K, Kirsch J, Bejarano P, Drexler I, Martinez F. Primary Neuroendocrine Tumor of the Thymus: Radiological and Pathological Correlation. J Radiol Case Rep 2020; 14:1-11. [PMID: 32184929 PMCID: PMC7060005 DOI: 10.3941/jrcr.v14i1.3737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Primary neuroendocrine tumors of the thymus are extremely rare. In this report, we describe a case of a 69 year-old man with an intermediate grade thymic neuroendocrine tumor. The radiologic and histopathologic features of thymic neuroendocrine tumors are discussed with reference to relevant literature.
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Affiliation(s)
- Kelsey Berman
- University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Jacobo Kirsch
- Imaging Department, Cleveland Clinic Florida, Weston, Florida, USA
| | - Pablo Bejarano
- Pathology Department, Cleveland Clinic Florida, Weston, Florida, USA
| | - Ian Drexler
- Imaging Department, Cleveland Clinic Florida, Weston, Florida, USA
| | - Felipe Martinez
- Imaging Department, Cleveland Clinic Florida, Weston, Florida, USA
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Ahmed A, Soin S, Patel S. A bimodal approach to thymic carcinoma with pericardial sac invasion. BMJ Case Rep 2019; 12:12/3/e229136. [PMID: 30936364 DOI: 10.1136/bcr-2018-229136] [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: 11/03/2022] Open
Abstract
Thymic carcinoma is a rare tumour of the thymus, representing less than 1% of thymic malignancies. 1 It has an annual incidence of 0.15-0.32 per 1 00 000 person-years. 2 It is found incidentally in 30% of the patients as an opacity on chest X-ray or with non-specific complaints of persistent cough, chest pain, fatigue, shortness of breath, arm and facial swelling, and upper airway congestion related to tumour extension. We present the case of a 59-year-old man with a history of Graves' disease status post radiation treatment presenting with cough and left lingual opacity on chest X-ray, confirmed to be thymic carcinoma with pericardial invasion and lymph node metastasis. We aim to discuss the presentation, treatment modalities and outcome associated with this rare tumour.
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Affiliation(s)
- Adnan Ahmed
- Department of Internal Medicine, Presence Saint Joseph Hospital, Chicago, Illinois, USA
| | - Sarthak Soin
- Department of Internal Medicine, Presence Saint Joseph Hospital, Chicago, Illinois, USA
| | - Sabah Patel
- Department of Internal Medicine, Presence Saint Joseph Hospital, Chicago, Illinois, USA
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