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Vol.53 No.2 contents | Japanese/English |
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- Case Report -
Synchronous Double Thymic Tumors (a Typical Carcinoid and Combined Thymic Epithelial Tumors) and Triple Lung Adenocarcinomas: Report of a Case
Tetsuya Yokosuka1, Toshiko Kobayashi11Department of Surgery, Tokyo Metropolitan Hiroo General Hospital, Japan
Background. We experienced a very rare case of synchronous multiple lung adenocarcinomas and double thymic tumors, including a typical thymic carcinoid tumor. Case. A 68-year-old female was admitted to our hospital due to the presence of multiple areas of mixed ground glass opacity and anterior mediastinal masses on chest computed tomography (CT). FDG-PET/CT showed abnormal accumulation in the right anterior mediastinal tumor; however, no significant uptake was observed in the left mediastinal tumor, multiple lung nodules or hilar and mediastinal lymph nodes. The lung nodule at S2 of the right upper lobe was diagnosed to be adenocarcinoma based on the findings of a transbronchial lung biopsy (TBLB). A percutaneous CT-guided fine needle biopsy (CTNB) of the right mediastinal mass was performed, and a pathological examination revealed a carcinoid tumor. No biopsy of the left tumor was performed. Right upper lobectomy of the lung with lymph node dissection and total thymectomy were performed via bilateral video-assisted thoracic surgery. Microscopically, there were 3 lepidic predominant invasive adenocarcinomas in the right upper lobe without lymph node metastasis. Concerning the mediastinal tumors, the right side tumor was diagnosed to be a thymic typical carcinoid tumor and the left side tumor was diagnosed as a combined thymic epithelial tumor containing type B3 and B2 thymoma in a ratio of 2:1, according to the World Health Organization (WHO) classification of the thymus. Under the administration of adjuvant chemotherapy for lung adenocarcinoma with oral uracil-tegafur (UFT), the patient is currently doing well without recurrence 20 months after undergoing surgery. Conclusions. A complete resection was performed in this case. However, various malignancies were present, including thymic epithelial tumors; therefore, providing strict postoperative follow-up for recurrence and the development of other primary cancers is necessary.
key words: Thymic typical carcinoid, Combined thymic epithelial tumors, Synchronous multiple thymic tumors, Synchronous multiple lung adenocarcinomas
Received: November 12, 2012
Accepted: April 24, 2013
JJLC 53 (2): 154-158, 2013
