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Norihiko Ikeda



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    EP1.15 - Thymoma/Other Thoracic Malignancies (ID 205)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Thymoma/Other Thoracic Malignancies
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.15-27 - One Case of Mucinous Carcinoma of Thymus Caused Bone Marrow Metastasis (ID 1574)

      08:00 - 18:00  |  Author(s): Norihiko Ikeda

      • Abstract

      Background

      Primary mucinous adenocarcinoma of the thymus is extremely rare neoplasm. Most thymic carcinomas metastasize to the mediastinal lymph node, pleura, pericardium and diaphragm. And distant metastasis to the extrathoracic organs such as liver, bone or kidney is considered rare. In this case, mucinous carcinoma of the thymus caused bone marrow metastasis and multiple bone metastasis is very rare.

      Method

      Case report

      Result

      A 51-year-old man. He was pointed out fecal occult blood test positive by medical checkup, and he was diagnosed the sigmoid colon cancer. After undergoing surgery for colon cancer, he was admitted to our hospital for treatment of mediastinal tumor. An anterior mediastinal tumor was pointed out by preoperative examinations.

      Computed tomography (CT) showed a tumor with maximum diameter of 55mm at the anterior mediastinam, including calcification and contrast effect and swollen lymph node. Thymoma or thymic cancer were suspected, so we surgical resection of mediastinal tumor and lymph node dissection were performed. Result of frozen section diagnosis was adenocarcinoma with mucinous component.

      Pathological findings showed that most of the tumor was a mucin component, and atypical cells with a small duct formed inside the mucin, signet ring cells were found. Immunohistochemistry, the neoplastic cells were positive for CK7 and CK20. Based on these features, diagnosis of this tumor was mucinous adenocarcinoma of thymus. Pathological stage was T2N1M0 stageIII.

      Two months after operation, radiation was performed at anterior mediastinum and one week after radiation compression fracture of lumbar vertebra was present. And five months after operation, pancytopenia was present. Examination of bone marrow aspiration biopsy was performed, and the cancer cells were detected. Bone marrow metastasis originated from thymic cancer was diagnosed as a result of comparing pathological features of the colon cancer and thymic cancer.

      Primary thymic adenocarcinoma is very rare and about 2.7% of all thymic carcinoma. Furthermore, only 16 cases have been reported and there have been no reported cases of thymic mucinous carcinoma caused bone marrow metastasis.

      Conclusion

      In this paper, we report a very rare and valuable case with consideration of some literature review.