A Clinical Observation of Thymic Epithelial Tumor Metastatic to Breast

Background: Thymic carcinoma is prone to early metastasis and invasion, while its metastasis to the breast is particularly unique. Case Report: We describe a case of thymic epithelial tumor metastatic to the breast fulfilling clinical diagnostic criteria. A 47-year-old female patient diagnosed with stage IV thymic carcinoma and previously treated with chemoradiation was diagnosed with metastatic breast cancer during a periodic review. Color Doppler ultrasonography showed a low-echo real occupancy in the breast. Pathological examination of the breast mass confirmed the diagnosis of thymic carcinoma metastasis. Conclusion: Hematogenous metastasis of thymic carcinoma to the breast is rare but not exceptional, and long-term survival can be expected with appropriate treatment.

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Mutational analysis of EGFR and KIT in thymic epithelial tumor

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.18049 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 18049-18049

Author(s):

K. Yoh ◽

Y. Nishiwaki ◽

G. Ishii ◽

K. Goto ◽

K. Kubota ◽

...

Keyword(s):

Tyrosine Kinase ◽

Tyrosine Kinase Inhibitors ◽

Thymic Carcinoma ◽

Kinase Inhibitors ◽

Mutational Analysis ◽

Direct Sequencing ◽

Egfr Mutations ◽

Epithelial Tumor ◽

Thymic Epithelial Tumor ◽

Number Of Patients

18049 Background: Thymic epithelial tumor has been reported to express the epidermal growth factor receptor (EGFR), and thymic carcinoma has recently been described to have overexpression of KIT. We investigated the prevalence of EGFR and KIT mutations in patients with thymoma and thymic carcinoma to explore the potential for a targeted therapy with tyrosine kinase inhibitors. Methods: Genomic DNA was isolated from 41 paraffin-embedded tumor samples including 24 thymoma and 17 thymic carcinoma. EGFR mutations in exons 18, 19 and 21, and KIT mutations in exons 9, 11, 13 and 17, were analyzed by PCR and direct sequencing. Protein expressions of EGFR and KIT were also evaluated by immunohistochemistry. Results: We detected the EGFR mutation in 2 of 20 thymoma, but none of thymic carcinoma had mutation. All of the detected EGFR mutations were missense mutations in exon 21 (L858R and G863D, respectively). Expression of EGFR was seen in 71% of thymoma and 53% of thymic carcinoma. On mutational analysis of KIT, only one thymic carcinoma displayed a missense mutation in exon 11 (L576P). Expression of KIT was observed in 88% of thymic carcinoma and 0% of thymoma. Conclusions: Our findings indicate that a small number of patients with thymic epithelial tumor exhibit somatic mutations of EGFR or KIT although expressions of EGFR or KIT are present frequently in thymic epithelial tumor. Further investigations are warranted to determine their susceptibility to tyrosine kinase inhibitors in the treatment of thymoma and thymic carcinoma with EGFR or KIT mutations. No significant financial relationships to disclose.

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A Rare Tumor with a Very Rare Initial Presentation: Thymic Carcinoma as Bone Marrow Metastasis

Case Reports in Pathology ◽

10.1155/2017/6497376 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Sonam Sharma ◽

Leelavathi Dawson

Keyword(s):

Bone Marrow ◽

Thymic Carcinoma ◽

Clinicopathological Characteristics ◽

Initial Presentation ◽

Unknown Etiology ◽

Histological Classification ◽

Rare Tumor ◽

Bone Marrow Metastasis ◽

Epithelial Tumor ◽

Thymic Epithelial Tumor

Tumors of thymus gland are rare and account for 0.2% to 1.5% of all the neoplasms. They constitute a heterogeneous group that has an unknown etiology and a complex as well as varied biology. This has led to difficulty in their histological classification and in predicting their prognostic and survival markers. Among them, thymic carcinoma is the most aggressive thymic epithelial tumor exhibiting cytological malignant features and a diversity of clinicopathological characteristics that can cause diagnostic dilemmas, misdiagnosis, and therapeutic challenge. We herein describe a case of a 60-year-old man who while undergoing evaluation for the cause of pancytopenia was discovered having bone marrow metastasis from an asymptomatic thymic carcinoma. Bone marrow metastasis is an extremely rare initial presentation of thymic carcinoma with only few cases reported in the literature.

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Extracellular volume fraction measurement correlates with lymphocyte abundance in thymic epithelial tumors

Cancer Imaging ◽

10.1186/s40644-020-00349-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Chao-Chun Chang ◽

Chia-Ying Lin ◽

Chang-Yao Chu ◽

Yi-Cheng Hsiung ◽

Ming-Tsung Chuang ◽

...

Keyword(s):

T1 Mapping ◽

Thymic Carcinoma ◽

Volume Fraction ◽

Extracellular Volume ◽

Quantitative Mri ◽

Low Grade ◽

Epithelial Tumor ◽

Thymic Epithelial Tumors ◽

Epithelial Tumors ◽

Thymic Epithelial Tumor

Abstract Background Recent advance in tissue characterization with parametric mapping imaging has the potential to be a novel biomarker for histopathologic correlation with thymic epithelial tumors (TETs). The purpose of our study is to evaluate MRI T1 mapping with the calculation of extracellular volume (ECV) fraction for histologic correlation with thymic epithelial tumor based on lymphocyte abundance. Methods A retrospective study including 31 consecutive patients (14 men and 17 women, median age, 56 years; interquartile range, 12 years) with TETs was performed. The T1 values and ECV were assessed by using quantitative MRI mapping techniques. Mann-Whitney U test, Kruskal-Wallis H test, and receiver operating characteristic curve analyses were used to assess discrimination between different types of TETs based on lymphocyte abundance. Results Extracellular volume was significantly higher in TETs with sparse lymphocyte, including type A, type B3, and thymic carcinoma, compared with those with abundant lymphocyte, including type B1, B2, and AB thymomas (42.5% vs 26.9%, respectively; p < 0.001). Extracellular volume was significantly higher in thymic carcinoma compared with low grade and high grade thymomas (48.6% vs 31.1% vs 27.6%, respectively; p = 0.002). Conclusions T1 mapping with the calculation of extracellular volume (ECV) fraction correlate with the WHO histologic classification of thymic epithelial tumor based on lymphocyte abundance.

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Pembrolizumab for Patients With Refractory or Relapsed Thymic Epithelial Tumor: An Open-Label Phase II Trial

Journal of Clinical Oncology ◽

10.1200/jco.2017.77.3184 ◽

2019 ◽

Vol 37 (24) ◽

pp. 2162-2170 ◽

Cited By ~ 37

Author(s):

Jinhyun Cho ◽

Hae Su Kim ◽

Bo Mi Ku ◽

Yoon-La Choi ◽

Razvan Cristescu ◽

...

Keyword(s):

Autoimmune Disease ◽

Partial Response ◽

Adverse Events ◽

Phase Ii ◽

Stable Disease ◽

Thymic Carcinoma ◽

Rapidly Progressive Glomerulonephritis ◽

Epithelial Tumor ◽

Thymic Epithelial Tumor ◽

Platinum Based Chemotherapy

PURPOSE Limited treatment options exist for patients with thymic epithelial tumor (TET) whose disease progresses after platinum-based chemotherapy. We conducted a phase II study of pembrolizumab in patients with TET to evaluate its efficacy and safety. METHODS Patients with histologically confirmed TET whose disease progressed after at least one line of platinum-based chemotherapy were eligible for the study. Patients were excluded if they had an active autoimmune disease requiring systemic treatment within the past year or documented history of clinically severe autoimmune disease. Patients received 200 mg of pembrolizumab intravenously every 3 weeks until tumor progression or unacceptable toxicity. The primary objective of response rate was assessed every 9 weeks by investigators. RESULTS Of 33 patients enrolled, 26 had thymic carcinoma and seven had thymoma. Of seven thymoma, two (28.6%; 95% CI, 8.2% to 64.1%) had partial response, and five (71.6%) had stable disease. Of 26 thymic carcinoma, five (19.2%; 95% CI, 8.5% to 37.9%) had partial response and 14 (53.8%) had stable disease. The median progression-free survival was 6.1 months for both groups. The most common adverse events of any grade included dyspnea (11; 33.3%), chest wall pain (10; 30.3%), anorexia (seven; 21.2%), and fatigue (seven; 21.2%). Five (71.4%) of seven patients with thymoma and four (15.4%) of 26 patients with thymic carcinoma reported grade ≥ 3 immune-related adverse events, including hepatitis (four; 12.1%), myocarditis (three; 9.1%), myasthenia gravis (two; 6.1%), thyroiditis (one; 3.0%), antineutrophil cytoplasmic antibody–associated rapidly progressive glomerulonephritis (one; 3.0%), colitis (one; 3.0%), and subacute myoclonus (one; 3.0%). CONCLUSIONS Pembrolizumab showed encouraging antitumor activity in patients with advanced TET. Given the high incidence of autoimmunity, additional studies are needed to identify those who can benefit from pembrolizumab without immune-related adverse events.

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Thymic epithelial tumor treatment in Japan: analysis of hospital cancer registry and insurance claims data, 2012–2014

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyz167 ◽

2019 ◽

Vol 50 (3) ◽

pp. 310-317 ◽

Cited By ~ 1

Author(s):

Hiroaki Kanemura ◽

Tomohide Tamura ◽

Naoki Nishimura ◽

Daiki Kobayashi ◽

Takahiro Higashi

Keyword(s):

Thymic Carcinoma ◽

Standard Treatment ◽

Claims Data ◽

Insurance Claims ◽

Tumor Treatment ◽

Epithelial Tumor ◽

Thymic Epithelial Tumors ◽

Thymic Epithelial Tumor ◽

Insurance Claims Data ◽

Health Insurance Claims

Abstract Introduction Thymic epithelial tumors are a rare type of neoplasm. Accordingly, it is difficult to perform phase III trials in patients with thymic epithelial tumors, and thus, no standard treatment has been established for these tumors. In this study, we aimed to investigate the current status of thymic epithelial tumor treatment in Japan. Methods This retrospective observational study enrolled patients with thymic epithelial tumor whose data were recorded in a nationwide Hospital-based Cancer Registry that was linked with health insurance claims data for the registered patients between 2012 and 2014. The patients’ treatment details were obtained from a health insurance claims database. Results A total of 813 patients with thymoma and 547 with thymic carcinoma were included in the analysis. Overall, 549 (67.5%) thymoma patients underwent surgical resection alone. Among patients with thymic carcinoma, 230 (42.0%) underwent initial surgery, and 124 (53.9%) received subsequent radiotherapy and chemotherapy. Chemotherapy regimens varied across the hospitals; overall, 21 and 22 regimens were used to treat thymoma and thymic carcinoma, respectively. Platinum-based combination regimens were predominantly selected for both diseases. Conclusions This study revealed the real-world patterns of thymic epithelial tumor treatment in Japan. Although the nature of this study did not enable the determination of optimal treatment strategies, the simultaneous analysis of nationwide registry, insurance, efficacy and prognostic data may contribute to the establishment of a standard treatment strategy for rarely occurring cancers such as thymic epithelial tumor.

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Spirituality and meaning-making in premenopausal women diagnosed with Stage IV metastatic breast cancer

PsycEXTRA Dataset ◽

10.1037/e642052013-002 ◽

2013 ◽

Author(s):

Cheryl Fisher

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Meaning Making ◽

Metastatic Breast ◽

Stage Iv ◽

Premenopausal Women

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Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up

General Hospital Psychiatry ◽

10.1016/j.genhosppsych.2016.10.002 ◽

2017 ◽

Vol 44 ◽

pp. 16-21 ◽

Cited By ~ 16

Author(s):

Michael H. Antoni ◽

Jamie M. Jacobs ◽

Laura C. Bouchard ◽

Suzanne C. Lechner ◽

Devika R. Jutagir ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Depressive Symptoms ◽

Cancer Patients ◽

Metastatic Breast ◽

Breast Cancer Patients ◽

Term Survival ◽

Long Term Survival

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Tumor immunity is related to 18 F‐FDG uptake in thymic epithelial tumor

Cancer Medicine ◽

10.1002/cam4.4176 ◽

2021 ◽

Author(s):

Hisao Imai ◽

Kyoichi Kaira ◽

Kosuke Hashimoto ◽

Hiroyuki Nitanda ◽

Ryo Taguchi ◽

...

Keyword(s):

Tumor Immunity ◽

Epithelial Tumor ◽

Fdg Uptake ◽

Thymic Epithelial Tumor

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Ultrasound Elastography in the Diagnosis of Malignant Cervical Lymphadenopathy in Children: Can It Replace Surgical Biopsy?

European Journal of Pediatric Surgery ◽

10.1055/s-0041-1729900 ◽

2021 ◽

Author(s):

Ahmed Elgendy ◽

Eslam Elhawary ◽

Mohamed M. Shareef ◽

Marwa Romeih ◽

Ahmed Ebeed

Keyword(s):

Prospective Study ◽

Color Doppler ◽

Cervical Lymphadenopathy ◽

Ultrasound Elastography ◽

Pathological Examination ◽

Benign Lesions ◽

Surgical Biopsy ◽

Cervical Lymph Nodes ◽

Benign Nature ◽

A Prospective Study

Abstract Introduction We aimed to assess the accuracy of ultrasound elastography in detecting pediatric malignant cervical lymph nodes, and if this modality can obviate the need for surgical biopsies. Material and Methods A prospective study from September 2017 to September 2020 included 64 children with persistent cervical lymphadenopathy. Patients were evaluated by meticulous history and physical assessment. B-mode ultrasound, color Doppler, and sonoelastography were conducted thereafter. Elastography scans were classified into five patterns, and patterns from 3 to 5 were considered as malignancies. All children underwent open biopsies followed by pathological examination. Results of tissue diagnosis were compared with patterns of elastography to determine its accuracy. Results Twenty-eight patients (43.8%) had malignant nodes and the remaining 36 (56.2%) were due to benign causes. Elastography patterns of 1 and 2 were documented in 30 patients, and all of them were diagnosed as benign lesions. Patterns of 3 to 5 were demonstrated in 34 patients. Out of them, 28 were confirmed as malignancies, while 6 children were of benign nature (false positive). Ultrasound elastography achieved sensitivity and specificity of 100 and 85.7%, respectively, and an overall accuracy of 90.6% in the differentiation between malignant and benign entities. The overall accuracy of B-mode and color Doppler were 75 and 82.2%, respectively. Conclusion Elastography is a useful tool that should be added to ultrasound modalities during the diagnosis of pediatric cervical lymphadenopathy. Surgical biopsy in eligible patients is imperative to commence proper therapy or to discharge the child. Despite favorable results of elastography, it cannot replace surgical biopsy or change its indications.

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