1998 Volume 12 Issue 1 Pages 66-73
A case of surgical treatment for metastatic lung tumor from thymic carcinoid is reported.
A forty-five year old male underwent thymusthymonectomy combined with partial lung and phrenic nerve resection in August 1991. Pathological diagnosis was thymic atypical carcinoid. He received radiotherapy postoperatively. In August 1993 during the follow-up, a new nodular shadow in the right lung field was pointed out, 2.5×1.5 cm in size. A suspicion of metastatic lung tumor from thymic carcinoid and also positive bone scintigraphy prompted a trial of systemic chemotherapy rather than operation at that time. VP-16 was started by per os every two weeks (50 mg/day). No remarkable change in the nodular shadow was noted until November 1994. In February 1995, a new infiltrating shadow in the lower lung field was complicated. Enlargement of the mass shadow, 3.0×2.0 cm in size, and consolidation of segment 8 were shown in August 1995. He was admitted for further examination and proper treatment in October 1995. Brochofiberscopic findings on admission showed a polypoid lesion which obstructed the orifice of B8 b. Biopsy specimens were obtained under a brochofiberscope, however a pathological diagnosis could not be made because the tissues were necrotic. Right lower lobectomy and mediastinal node dissection were conducted on November 7 th. Pathological diagnosis was metastatic atypical carcinoid.
