Metastatic thymic carcinoma: A case we should always consider in the differential diagnosis of a metastatic cancer of unknown primary site

Abstract Background: Complete recovery from retroperitoneal squamous cell carcinoma of unknown primary site treated by multidisciplinary therapy is extremely rare.Case presentation: A 78-year-old man was referred to our hospital due to a mass measuring 8 cm in size in the left pelvic retroperitoneal area, which was diagnosed as a cancer of unknown primary site. The pathological type was squamous cell carcinoma. The left iliac artery/vein and ureter were involved in the tumor, and the tumor caused severe left leg pain. Although inflammation and symptoms were severe, palliative radiotherapy was considered. After that, biweekly combined therapy with docetaxel, cisplatin, and fluorouracil was planned. After 5 courses of chemotherapy, the tumor diameter reduced from 11.6 cm to 4 cm in size. In addition, the border between the iliac vessels, urinary tract and tumor became apparent. The patient underwent radical resection of the tumor 8 months after the treatment started. The left ureter and the external/internal iliac artery were preserved, but the external iliac vein was sacrificed because of the possibility of tumor invasion. The postoperative course was free of complications, and the patient was discharged 10 days after the operation. The histopathological findings showed no residual viable tumor cells or foreign body-type giant cells with necrosis. The pathological effect of chemotherapy was defined as Grade 3 (pathological complete response). The patient has experienced no recurrence or distant metastasis for 4 years.Conclusions: Multidisciplinary therapy succeeded in treating a retroperitoneal squamous cell carcinoma of unknown primary site with preservation of organ function.

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Cancer of Unknown Primary Site

Oncology ◽

10.1007/0-387-31056-8_61 ◽

2007 ◽

pp. 1119-1132 ◽

Cited By ~ 2

Author(s):

F. Anthony Greco ◽

John D. Hainsworth

Keyword(s):

Cancer Of Unknown Primary ◽

Primary Site ◽

Unknown Primary ◽

Unknown Primary Site

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Cancer of unknown primary site

Oxford Textbook of Oncology ◽

10.1093/med/9780199656103.003.0059 ◽

2016 ◽

pp. 965-974

Author(s):

Nicholas Pavlidis ◽

George Pentheroudakis

Keyword(s):

Expression Profiling ◽

Cancer Of Unknown Primary ◽

Primary Site ◽

Unknown Primary ◽

Unknown Primary Site ◽

Clinical Intuition ◽

Genome Wide ◽

Genetic Signatures ◽

Genome Wide Expression ◽

Tumour Origin

This chapter covers cancer of unknown primary site (CUP), and includes information on epidemiology, molecular biology, pathology, and multidisciplinary management of clinicopathological subsets. Previously, these tumours were diagnosed and treated based on clinical presentation, light microscopy and clinical intuition. Today, the majority of cancers of unknown primary site are becoming less unknown, more accurately classified, and appropriately treated by the use of multiplex or genome-wide expression profiling platforms. These techniques allow for precise and correct knowledge of the true tumour origin, leading to more rational and effective treatment. However, there also may be genetic signatures that are primary-independent, pro-metastatic, and possibly CUP-specific.

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