Cancer of unknown primary (CUP) is a well-known entity that can present in a multitude of clinical presentations. Based on the extent and organ of involvement, the presentation will be varied. For instance, patients presenting with axillary lymphadenopathy would lead toward a primary breast cancer, whereas patients presenting with abdominal distention due to ascites would tend toward a gastrointestinal origin. We present a case of a 73-year-old female who presented with an abdominal wall mass; on laparoscopy, she was found to have a spigelian hernia due to an omental metastatic lesion from a CUP.
Thymic carcinoma is a rare, aggressive neoplasm with low 5-year survival rates ranging
from 28 to 67%. Initial presentation with spinal or bone metastasis in primary
thymic carcinoma is extremely rare. Thymic carcinoma, compared with thymoma, has higher
recurrence rates and worse survival. We report one patient, a 29-year-old African-American
male, with thymic carcinoma with metastasis to the epidural space (with cord compression),
multiple bony structures (T10–L1) and left supraclavicular lymph node.
Immunohistochemical staining was CD5 and c-Kit positive, consistent with thymic carcinoma.
Patient underwent T12–L1 laminectomy with tumor resection to relieve cord
compression and leg numbness/weakness. Patient was deemed a good candidate for
rehabilitation. Soon after starting a rehabilitation program, he quickly demonstrated
gains in gait distance with little to no assistance. Follow-up appointments with oncology
were scheduled, and further planning of radiation and chemotherapy treatments were
discussed.
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