Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 57-year-old white woman presented with pericardial effusion and an anterior superior mediastinal mass protruding through the sternum. The diagnosis of thymoma was established by the light and electron microscopic features of a biopsy specimen and a pericardial aspirate. The tumour was a thymic carcinoma, a recently described variant characterized by cellular atypia, enhanced invasiveness, and a higher incidence of metastases. Presentation as an anterior chest wall mass has not been described. Response to radiotherapy was slow and incomplete, and tumour progression occurred during treatment with cisplatin. The chemotherapy of thymoma is reviewed: some apparent responses to agents that are primarily lympholytic may represent the elimination of non-neoplastic lymphocytes from the tumour mass, with spurious radiological improvement and theoretically a risk of tumour enhancement.
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PMID:Invasive thymoma: unique presentation as an anterior chest wall mass. 688 42

The lymphocytes that accompany thymomas express an immature T-cell phenotype, as usually demonstrated by CD1 or TdT immunoreactivity. Even when thymomas metastasize or occur in ectopic sites, the infiltrating T lymphocytes show this unique immature phenotype, contrasting with thymic and nonthymic carcinomas, in which the infiltrating T lymphocytes typically show a mature phenotype (CD1 and TdT negative). Therefore, the presence of an immature T-cell population in an epithelial tumor strongly supports a diagnosis of thymoma. The availability of an antibody that consistently marks immature T-cells in routine paraffin sections would be of great help in the study of thymic tumors. In this report, we describe the use of MIC2 antibody (013), which has been widely used for the diagnosis of Ewing's sarcomas and peripheral primitive neuroectodermal tumors because it intensely stains thymocytes. Immunohistochemical staining was performed on paraffin sections of normal/hyperplastic thymus (18 cases), thymoma (62 cases), thymic carcinoma (nine cases), tumors showing borderline features between thymoma and thymic carcinoma (three cases), and ectopic hamartomatous thymoma (two cases). T-cell and B-cell antibodies were also applied to aid in the interpretation. In the normal thymus, almost all lymphocytes in the cortex stained with 013, whereas fewer than 5% of those in the medulla were 013 positive. In thymomas, including the three ectopic thymomas and the single case of metastatic thymoma, most lymphocytes were 013 positive, except the spindle-cell foci (medullary thymoma or medullary component of mixed thymoma), in which the percentage of 013-positive lymphocytes was lower (5-30%). Within the pale foci of "medullary differentiation" and the perivascular spaces of lymphocyte-rich thymomas, few lymphocytes showed 013 positivity, indicating that the T lymphocytes in these areas were more mature. None of the thymic carcinomas harbored 013-positive lymphocytes. Among the three cases of borderline thymoma/thymic carcinoma, only one harbored 013-positive lymphocytes. The 013-positive lymphocytes were not seen in the ectopic hamartomatous thymomas. In normal lymph nodes and nonthymic carcinomas studied as controls, there were no or at most small numbers of isolated 013-positive lymphocytes. We conclude that interpreted in the proper context, MIC2 antibody can serve as a useful marker of immature T-cells and thus help in the confirmation of a diagnosis of thymoma in small biopsy specimens, ectopic thymoma, or metastatic thymoma; in the distinction between invasive thymoma and thymic carcinoma; and in the classification of thymomas.
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PMID:The MIC2 antibody 013. Practical application for the study of thymic epithelial tumors. 757 70

Primary thymic carcinoma is a rare neoplasm that in contradistinction to thymoma, is not supposed to be associated with a paraneoplastic syndrome. A 73-year-old man, with new onset of disorientation, was found to have an elevated serum calcium level as the cause. Computed tomography demonstrated a mediastinal mass, pericardial invasion, and metastases to the lung. Examination of a biopsy specimen revealed thymic squamous cell carcinoma. Thus, a paraneoplastic syndrome, in this case hypercalcemia, does not exclude primary carcinoma of the thymus.
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PMID:Squamous cell carcinoma of the thymus with paraneoplastic hypercalcemia. 777 75

Eight cases of thymic carcinoma (mean age 62 years, 5 males and 3 females) were treated in our hospital from Apr. 1988 to Mar. 1993, which were 21% of thymic epithelial tumors. The histologic subtypes of thymic carcinoma were 3 squamous, 4 undifferentiated, and 1 adenocarcinoma, respectively. Computed tomography showed extrathymic metastases to the mediastinal lymph nodes in 6 cases. All cases underwent thoracotomy, and postoperative radiotherapy or chemotherapy were performed. A case of squamous cell carcinoma in stage II who underwent total resection followed by irradiation is alive and disease free 5 years after surgery. However, the remaining 7 cases died of the disease within 29 months. 8 cases of thymic carcinoma and 7 of thymoma were studied immunohistologically on the formalin-fixed and paraffin-embedded tissues. Higher positivity of EMA in thymic carcinoma was noted comparing to ordinary thymoma, suggesting that EMA is a useful parameter of potential malignancy of the thymic epithelial neoplasms.
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PMID:[Eight cases of thymic carcinoma]. 783 17

From 1972 to 1990, we treated eight cases of thymic carcinoma (6 squamous cell and 2 small cell carcinomas). According to the classification by Masaoka et al., they consisted of one stage I, four stage III, one stage IVa, and two stage IVb. A complete resection of the primary tumour could be done in only three patients; the others had diagnostic biopsy and then radiation treatment. Four of five patients had a prolonged regression of the primary tumors after irradiation at 40-61.2 Gy. Six patients suffered from extrathoracic metastases. All patients received systemic chemotherapy with different regimens to counter either metastatic or locally recurrent lesions. Only two patients (with a regimen including cyclophosphamide, doxorubicin, and vincristine) obtained a partial response. The median survival of the eight patients was 70 months after surgical operation. The identification of an effective drug combination may thus improve the long-term prognosis of thymic carcinoma since radiotherapy is able to control primary lesions, even in the case of unresectable advanced disease.
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PMID:Treatment and prognosis of primary thymic carcinoma. 838 24

Nineteen cases of thymic carcinoma treated in our hospital (mean age 60.0 years, seven males and twelve females) were studied clinically. Thirteen cases (68.4%) had subjective symptom; for example, chest pain, face edema or cough. Two cases (10.5%) had the associated diseases; one had gammaglobulinemia, the other one had Cushing syndrome and hypogammaglobulinemia. The histological subtypes were eleven squamous cell carcinomas (SCC) (57.9%), three undifferentiated carcinomas, two small cell carcinomas, one papillary adenocarcinoma and one lymphoepithelioma-like carcinoma. The 5 year survival rate of all cases was 42.7%. The 10 years survival rate was 21.4%. The median survival time was 56.1 months. There were one Stage I case, nine stage III cases, four stage IVa cases and five stage IVb cases. More than stage III cases were eighteen (94.7%). Five cases of stage IVb were T2N1M0, T3N1M0, T3N0M1 and T4N0M1. The 5 year survival rate of SCC was 65.6%, and that of the other subtypes was 14.3%. The cases resected completely were only eight cases (42.1%), and the 5 year survival rate of these was 70.0%. On the other hand, the rate of five cases resected incompletely was 53.3%. Metastasis occurred in 12 cases (63.2%). Metastasis occurred frequently in pleura, lymphnode, lung, bone and liver. The radiotherapy for SCC was effective and the 5 year survival rate was 83.3%. Furthermore, there were some long survivors in the cases undergone incomplete resections by postoperative radiotherapy jointly. On the other hand, the chemotherapy was not effective in our series. However, it was reported recently that the regimen including cisplatin was effective. So it was impressed that the combined therapy including surgery radiotherapy and induction chemotherapy would be important to obtain better results.
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PMID:[Clinical study of nineteen thymic carcinomas]. 871 65

Thymic carcinoma is a rare malignant neoplasm of the thymic epithelium, distinguished from invasive thymoma by the presence of malignant cytology and a greater incidence of local invasion and embolic metastases. Some common features of thymic carcinomas include (a) large and highly aggressive anterior mediastinal mass; (b) areas of necrosis, hemorrhage, calcification, or cyst formation; (c) gross invasion of contiguous mediastinal structures and wide spread to involve distant intrathoracic sites; (d) high incidence of extrathoracic metastases; (e) broad age range, with an average of 46 years; (f) very low incidence of paraneoplastic syndromes; and (g) very poor prognosis. Three case reports are presented, followed by an overview of the disease with emphasis on the radiographic features.
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PMID:Thymic carcinoma: case reports and review. 877 Aug 29

We report a case of thymic basaloid carcinoma in a 65-yr-old man who presented with symptoms referable to the mass effect of the tumor. The tumor arose in association with a multilocular thymic cyst and microscopically was characterized by islands, nests, and cords of basaloid cells. The tumor cells demonstrated prominent palisading around most of the neoplastic islands and nests. The tumor was excised, and there was no evidence of recurrent or metastatic disease in the 6-mo follow-up period. Including the current case, seven cases of basaloid thymic carcinoma have been reported in the English literature, four of which (57%) were associated with a multiloculated thymic cyst. Follow-up was available on three patients. Although no patient has died of tumor, pulmonary metastases developed in two patients. Although basaloid thymic carcinoma is currently considered a tumor of low-grade histology, more cases need to be studied to determine the long-term prognosis of these tumors.
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PMID:Thymic basaloid carcinoma: a case report and review of the literature. 882 51

A 43-year-old female with a thymic carcinoma spreading to the extrathorac region is reported. She had received radiation and chemotherapy, after that thymic carcinoma was extirpated. Five months later, the patient was noticed to have a right side hemiparesis, following consciousness disturbance. CT and MRI revealed a left thalamic mass with a heterogenous enhancement effect. The tumor was diminished dramatically due to radiation. Metastasis of thymic carcinoma to the central nervous system is discussed.
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PMID:[A case of thymic carcinoma with brain metastasis]. 938 57

Bone metastases can be the first symptom of a tumor. The case of a 65-year-old patient with a thymoma exhibiting primary metastases in the lung and bone is presented. Initially, a tumor was suspected because of an osteolytic destruction of the right proximal femur posing a high risk of fracture. Further diagnostic procedures detected a partially sclerosing mediastinal bulk and bilateral lung metastases. The histological investigation of the resected proximal femur and needle biopsy of the mediastinal bulk showed an extrathoracically metastasized polygonal cell thymoma. This metastasizing pattern is common in thymic carcinoma but very rare in thymoma. In addition to the case presentation, a review of the current literature on histological classification, therapy, and prognosis is given.
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PMID:[Thymoma with primary osseous and pulmonary metastases. Case report and review of the literature]. 1155 98


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