A resected case of large-cell neuroendocrine carcinoma of the thymus

Abstract

A 71-year-old woman presented with an abnormal chest shadow on routine chest radiograph. Contrast enhanced chest computed tomography (CT) showed a heterogeneous mass in the anterior mediastinum with invasion to the right lung, pericardium, and superior vena cava (SVC). Positron emission tomography-CT showed high FDG accumulation (SUVmax: 13.51). Under a diagnosis of invasive thymoma or thymic carcinoma, the patient underwent tumor resection with combined resection of the right upper lobe of the lung, pericardium, phrenic nerve, and SVC. The tumor was white and solid at the cut surface. Histopathologically, the tumor was diagnosed as large-cell neuroendocrine carcinoma of the thymus. Twelve months later, mediastinal lymph node and multiple liver metastases developed. The patient was treated with combination chemotherapy consisting of carboplatin and etoposide for 4 cycles, leading to a partial response. However, multiple bone metastases were newly diagnosed.