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. 2019:60:53-57.
doi: 10.1016/j.ijscr.2019.05.057. Epub 2019 Jun 8.

Resected thymic large cell neuroendocrine carcinoma: A case report and review of the literature

Shogo Ogata  1 , Ryo Maeda  1 , Masaki Tomita  2 , Yuichiro Sato  3 , Takanori Ayabe  1 , Kunihide Nakamura  4
Affiliations

Resected thymic large cell neuroendocrine carcinoma: A case report and review of the literature

Shogo Ogata et al. Int J Surg Case Rep. 2019.

Abstract

Introduction: Large cell neuroendocrine carcinoma (LCNEC) of the thymus is an extremely rare neoplasm.

Presentation of case: We report a rare case of LCNEC of the thymus in a 55-year-old woman. Her chest roentgenogram during a routine checkup revealed an abnormal shadow in the mediastinal left upper lung field. Chest computed tomography showed an anterior mediastinal mass measuring 4.8 × 4.0 cm. Positron emission tomography with 18F-fluorodeoxyglucose (FDG) showed high FDG accumulation at the lesion. To obtain a definitive diagnosis and achieve complete resection, a surgery was performed. The postoperative diagnosis was thymic LCNEC; it was classified as a Masaoka stage III tumor due to the invasion of tumor cells into the left lung. Postoperatively, the patient received adjuvant chemotherapy and survived without any signs of recurrence for 30 months after surgery.

Discussion/conclusion: The detailed clinical features of thymic LCNEC remain unknown because of its rarity. In total, 20 cases of resection for LCNEC, including the present case, have been reported in the English language literature; we have presented a review of these cases and discussed the optimal therapy for this rare and virulent tumor of the thymus.

Keywords: Large cell neuroendocrine carcinoma; Surgery; Thymic carcinoma; Thymus.

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Figures

Fig. 1
Fig. 1
A computed tomographic scan of the chest shows an anterior mediastinal mass.
Fig. 2
Fig. 2
A computed tomographic scan of the chest shows an anterior mediastinal mass.
Fig. 3
Fig. 3
Magnetic resonance imaging of the chest shows high intensity on T2-weighted images with suspected invasion to the upper lobe of the left lung.
Fig. 4
Fig. 4
Positron emission tomography with 18F-fluorodeoxyglucose shows high 18F-fluorodeoxyglucose accumulation at the lesion.
Fig. 5
Fig. 5
(A) The tumor cells with hyperchromatic nuclei proliferatein layered nest pattern with peripheral palisading and necrosis. Tumor embolism of the left innominate vein (B) or venous permeation in the tumor (C) are found. (D) Tumor cells are immunohistochemically positive for synaptophysin.
See this image and copyright information in PMC

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