Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Rare Case of Primary Thymic Adenocarcinoma Mimicking Small Cell Lung Cancer

  • Cho, Eun Na (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Hye Sung (Department of Pathology, Yonsei University College of Medicine) ;
  • Kim, Tae Hoon (Department of Radiology, Yonsei University College of Medicine) ;
  • Byun, Min Kwang (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Hyung Jung (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Ahn, Chul Min (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chang, Yoon Soo (Department of Internal Medicine, Yonsei University College of Medicine)
  • Received : 2014.08.29
  • Accepted : 2014.10.28
  • Published : 2015.02.28
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Abstract

Primary thymic adenocarcinoma is a very rare malignancy of the anterior mediastinum with no standardized treatment. A 36-year-old male patient presented with hoarseness over the past 3 months. A chest computed tomography (CT) scan showed an infiltrative mass to the proximal vessels and aortic arch in left upper mediastinum ($4.1{\times}3.1{\times}5.4cm$). Brain magnetic resonance imaging (MRI) showed focal lesions, suggesting metastasis in the left frontal lobe. A thoracoscopic biopsy of the mediastinal mass confirmed a primary thymic adenocarcinoma forming a glandular structure with atypia of tumor cells. The patient received four cycles of systemic chemotherapy, consisting of etoposide and cisplatin, with concurrent radiotherapy (6,000 cGy/30 fractions) to the mediastinal lesion and the metastatic brain lesion (4,200 cGy/12 fractions). A follow-up chest CT scan and brain MRI showed a decrease in the size of the left upper mediastinal mass and brain lesion. We report a rare case of the primary thymic adenocarcinoma with a literature review.

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References

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