Aggressive course of carcinoma showing thymus-like differentiation with distant metastasis and temporary activity of cisplatin and irinotecan.

  Introduction Carcinoma showing thymus-like differentiation is a rare type of thyroid cancer arising from a remnant of thymic epithelium. Patients with carcinoma showing thymus-like differentiation have a relatively better prognosis when diagnosed in the early stage. Surgery plays a crucial role, and patients with metastatic carcinoma showing thymus-like differentiation are treated with chemotherapy; however, metastatic carcinoma showing thymus-like differentiation is reported to be refractory to chemotherapy. Case report A 54-year-old male patient presented with hoarseness and a left cervical tumour. The patient was histologically diagnosed with squamous cell carcinoma by a needle biopsy specimen from a left inferior thyroid tumour. Immunohistochemistry studies showed that the specimen stained positive for CD5, slightly positive for CD117 (cKIT), and negative for thyroglobulin, thyroid transcription factor 1 and calcitonin. The tumour therefore seemed to be a carcinoma arising from thymic epithelium. A computed tomography scan revealed the primary site to arise from the left inferior thyroid. The patient was diagnosed with metastatic carcinoma showing thymus-like differentiation involving the lungs, liver and brain. Four cycles of cisplatin and irinotecan combination chemotherapy were administered according to the front-line chemotherapy protocol for thymic carcinoma. The chemotherapy had a significant beneficial effect, such that the patient's general cond...
Source: Head and Neck Oncology - Category: Cancer & Oncology Source Type: research