HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Pier Luigi Filosso Guglielmo Maria Actis Dato Enrico Ruffini Maurizio Mancuso Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Filosso, P. L. Articles by Mancuso, M. Search for Related Content PubMed PubMed Citation Articles by Filosso, P. L. Articles by Mancuso, M. Related Collections Mediastinum

J Thorac Cardiovasc Surg 2004;127:1215-1219
© 2004 The American Association for Thoracic Surgery

Brief communication

Multidisciplinary treatment of advanced thymic neuroendocrine carcinoma (carcinoid): Report of a successful case and review of the literature

^a Department of Thoracic Surgery, University of Torino Italy San Giovanni Battista Hospital, Torino, Italy
^b Department of Cardiac Surgery, University of Torino Italy San Giovanni Battista Hospital, Torino, Italy
^c Service of Medical Oncology, Civil Hospital, Ivrea, Torino, Italy
^d Service of Radiation Therapy, Civil Hospital, Ivrea, Torino, Italy

Received for publication August 22, 2003; revisions received September 30, 2003; accepted for publication December 4, 2003.

^* Address for reprints: Pier Luigi Filosso, MD, University of Torino Italy, Department of Thoracic Surgery, San Giovanni Battista Hospital, Via Genova, 3, 10126 Torino, Italy
pierluigifillosso@tiscalinet.it

The first 300 words of the full text of this article appear below.

Thymic carcinoid (TC) is a rare entity: since the first description by Rosai and Higa¹ in 1972, approximately 150 cases have been reported in the literature. These tumors are frequently associated with endocrinopathies (Cushing syndrome or multiple endocrine neoplasia type 1; MEN-1) and carry a poor prognosis.^2,3 TCs present an aggressive biological behavior with a tendency to invade adjacent structures (mediastinal fatty tissue, lung, pericardium, and great vessels) and with a tendency for local recurrences or distant hematogenous metastases.

Surgery, when feasible, represents the treatment of choice^3-5 even if, in some cases, radical resection is not achieved. The role of neoadjuvant or adjuvant therapy has not yet been assessed. We describe the successful multidisciplinary management of a giant TC treated with neoadjuvant radiotherapy/chemotherapy, radical surgical resection, and preoperative, intraoperative, and postoperative therapy with a somatostatin analog. In addition, we provide a review of the recent literature about the management of these tumors.

Clinical summary

A 39-year-old man underwent a bioptic left anterior mediastinotomy for a large mediastinal mass, discovered after he presented with cough and dyspnea. Histology revealed grade 2 neuroendocrine carcinoma (atypical carcinoid) of the thymus. Neoplastic tissue strongly expressed somatostatin receptors (sst₂), and chromogranin immunostaining was positive. Total body computed tomographic (CT) scan showed involvement of the anterior mediastinum, of the thoracic inlet, and of the left lung (Figure 1). No distant metastases were seen. Indium 111 diethylenetriamine pentaacetic acid pentetreotide scintigraphy (Octreoscan; Mallincrodt Medical BV, Zaltbommel, The Netherlands) confirmed an elective uptake only in correspondence of the tumor (Figure 2).

View larger version (153K): [in this window] [in a new window]   Figure 1. CT scan of a giant invasive thymic carcinoid.

View larger version (139K): [in this window] [in a new window]   Figure 2. Octreoscan shows an elective uptake only in correspondence with the thoracic lesion: no other pathologic images are evident.

This article has been cited by other articles:

				M. P. McEvoy, B. S. Rich, M. New, L. H. Tang, and M. P. La Quaglia Thymic Carcinoid Presenting With Cushing's Syndrome in a 17-Year-Old Boy: A Case Report and Review of the Literature J. Clin. Oncol., September 1, 2011; 29(25): e716 - e718. [Full Text] [PDF]

				D. Whitaker Thymic neuroendocrine carcinoma (carcinoid): What if octreotide scanning is negative? J. Thorac. Cardiovasc. Surg., November 1, 2004; 128(5): 801 - 801. [Full Text] [PDF]

				P. L. Filosso Reply J. Thorac. Cardiovasc. Surg., November 1, 2004; 128(5): 801 - 801. [Full Text] [PDF]