Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 6;7(1):12.
doi: 10.1186/s40792-020-01094-3.

Pigmented spindle cell variant of a thymic atypical carcinoid in an octogenarian

Yasushi Sakamaki  1 , Ryo Tanaka  2 , Daisuke Ishida  2 , Hiromi Tsuji  3 , Asako Mike  3 , Hironao Yasuoka  3
Affiliations

Pigmented spindle cell variant of a thymic atypical carcinoid in an octogenarian

Yasushi Sakamaki et al. Surg Case Rep. .

Abstract

Background: A pigmented carcinoid is an extremely rare variant of carcinoid characterized by melanin pigmentation of the tumor, with only five cases described in the literature. In addition, thymic carcinoids are rare in elderly patients and their prognosis after resection of the carcinoid tumor is unclear.

Case presentation: An anterior mediastinal tumor was incidentally found in an 82-year-old man who had been diagnosed with acute thoracic empyema. The tumor was considered most likely to be a noninvasive thymoma or thymic carcinoma for which surgery was indicated after the resolution of the empyema. The tumor was completely resected 4 months after the empyema surgery, and the patient had an uneventful postoperative course. A cut surface of the resected specimen was extensively pigmented and appeared dark-brownish, with abundant melanin pigmentation later confirmed in the spindle-shaped tumor cells. Based on the histologic examination and immunohistochemical study, melanoma was eliminated as a differential diagnosis and the tumor was diagnosed as a pigmented atypical carcinoid of the thymus.

Conclusions: This report provides additional knowledge on thymic pigmented carcinoids and thymic atypical carcinoids in elderly patients.

Keywords: Atypical carcinoid; Pigmented carcinoid; Spindle cell carcinoid; Thymic carcinoid; Thymic neuroendocrine tumor.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Tumor appearance on diagnostic imaging. a Computed tomography showing a solitary tumor in the anterior mediastinum. b Diffusion-weighted magnetic resonance image showing a high-intensity signal in the tumor
Fig. 2
Fig. 2
Gross appearance and histologic findings of the resected tumor. a Dark-brownish cut surface. b Hematoxylin–eosin staining revealing nesting proliferation of the spindle-shaped tumor cells and marked dark-brownish pigmentation in the macrophages. c Fontana–Masson staining confirming melanin in the pigmented cells
Fig. 3
Fig. 3
Immunoreactivity of the tumor cells revealing the epithelial and neuroendocrine nature. a Cytokeratin AE1/AE3. b Synaptophysin. c CD56
See this image and copyright information in PMC

References

    1. Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, et al. One hundred years after ‘Carcinoid’: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26:3063–3072. doi: 10.1200/JCO.2007.15.4377. - DOI - PubMed
    1. Travis WD, Brambillia E, Burke AP, Marx A, Nicholson AG. World Health Organization classification of tumours of the lung, pleura, thymus and heart. Lyon: IARC Press; 2015. - PubMed
    1. Rosai J, Higa E. Mediastinal endocrine neoplasm of probable thymic origin related to carcinoid tumor. Cancer. 1972;29:1061–1074. doi: 10.1002/1097-0142(197204)29:4<1061::AID-CNCR2820290456>3.0.CO;2-3. - DOI - PubMed
    1. Ströbel P, Zettl A, Shilo K, Chuang WY, Nicholson AG, Matsuno Y, et al. Tumor genetics and survival of thymic neuroendocrine neoplasms: a multi-institutional clinicopathologic study. Genes Chromosomes Cancer. 2014;53:738–749. doi: 10.1002/gcc.22183. - DOI - PubMed
    1. Goel A, Addis BJ. Pigmented atypical carcinoid of the lung. Histopathology. 2007;51:263–265. doi: 10.1111/j.1365-2559.2007.02760.x. - DOI - PubMed

LinkOut - more resources