Continuing challenges of primary neuroendocrine tumours of the thymus: A concise review

Lau, Joel; Cvasciuc, Titus; Simpson, Duncan; Jong, Mechteld C. de; Parameswaran, Rajeev

doi:10.1016/j.ejso.2022.07.017

Cited by 3 publications

(4 citation statements)

References 103 publications

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“…Limited data have been published so far in order to address the specific field of thymic neuroendocrine tumours; however, a surgical approach is associated with the most significant improvement, including resection of the lymph nodes and distant metastases (if feasible). Additional radiotherapy, chemotherapy, treatment with somatostatin analogues, and PRRT was recommended based on an individual decision [ 67 ].…”

Section: Results: Sternal Metastases—a Multidisciplinary Perspective ...mentioning

confidence: 99%

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Carsote,

Terzea,

Vasilescu

et al. 2023

Diagnostics

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We aimed to overview the most recent data on sternal metastases from a multidisciplinary approach (diagnosis strategies, outcome, and histological reports). This narrative review based on a PubMed search (between January 2020 and 22 July 2023) using key words such as “sternal”, “manubrium”, and “metastasis” within the title and/or abstract only included original papers that specifically addressed secondary sternal spreading of cancer in adults, for a total of 48 original articles (14 studies and 34 single case reports). A prior unpublished case in point is also introduced (percutaneous incisional biopsy was used to address a 10 cm sternal tumour upon first admission on an apparently healthy male). The studies (n = 14) may be classified into one of three groups: studies addressing the incidence of bone metastases (including sternum) amid different primary cancers, such as prostate cancer (N = 122 with bone metastases, 83% of them with chest wall metastases), head and neck cancers (N = 3620, 0.8% with bone metastases, and 10.34% of this subgroup with sternum involvement); and glioblastoma (N = 92 with bone metastases, 37% of them with non-vertebral metastases, including the sternum); assessment cohorts, including breast cancer (N = 410; accuracy and sensitivity of PET/CT vs. bone scintigraphy is superior with concern to sternum spreading) and bone metastases of unknown origin (N = 83, including a subgroup with sternum metastases; some features of PET/CT help the differentiation with multiple myeloma); and cohorts with various therapeutic approaches, such as palliative arterial embolization (N = 10), thymic neuroendocrine neoplasia (1/5 detected with sternum metastases), survival rates for sternum metastases vs. non-sternum chest wall involvement (N = 87), oligo-metastatic (sternal) breast cancer (3 studies, N = 16 for all of them), oligo-metastatic head and neck cancer (N = 81), conformal radiotherapy (N = 24,215, including an analysis on sternum spreading), and EBRT followed by MR-HIFU (N = 6). Core data coming from the isolated case reports (N = 34) showed a female to male ratio of 1.6; the females’ ages were between 34 and 80 (mean of 57.28) and the males’ ages varied between 33 and 79 (average of 58.78) years. The originating tumour profile revealed that the most frequent types were mammary (N = 8, all females) and thyroid (N = 9, both women and men), followed by bladder (N = 3), lung (N = 2), and kidney (N = 2). There was also one case for each of the following: adenoid cystic carcinoma of the jaw, malignant melanoma, caecum MiNEN, a brain and an extracranial meningioma, tongue carcinoma, cholangiocarcinoma, osteosarcoma, and hepatocellular carcinoma. To our knowledge, this is the most complex and the largest analysis of prior published data within the time frame of our methods. These data open up new perspectives of this intricate, dynamic, and challenging domain of sternum metastases. Awareness is a mandatory factor since the patients may have a complex multidisciplinary medical and/or surgical background or they are admitted for the first time with this condition; thus, the convolute puzzle will start from this newly detected sternal lump. Abbreviations: N = number of patients; n = number of studies; PET/CT = positron emission tomography/computed tomography; EVRT = external beam radiotherapy; MR-HIFU = magnetic resonance-guided high-intensity focused ultrasound; MiNEN = mixed neuroendocrine-non-neuroendocrine tumour.

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Section: Results: Sternal Metastases—a Multidisciplinary Perspective ...mentioning

confidence: 99%

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Carsote,

Terzea,

Vasilescu

et al. 2023

Diagnostics

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“…Patients may experience symptoms and signs such as cough, chest pain,shortness of breath, or superior vena cava obstruction. Additionally,at the time of diagnosis, up to 62% of patients may have mediastinal lymph node metastasis, while distant metastasis occurs in 20-30% of patients, most commonly affecting the bones, lungs,and liver [14] .…”

Section: Discussionmentioning

confidence: 99%

Recurrent thymic carcinoma treated with anterior median thoracotomy, innominate vein replacement for superior vena cava, and iodide implantation: A case report and review of the literature

Chen,

Qu,

Zhang

et al. 2024

Preprint

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Thymic neuroendocrine tumors are rare malignant tumors with neuroendocrine functions located in the anterior mediastinum thymic region. They exhibit a high degree of malignancy and can early invade surrounding fat,pericardium, pleura, major blood vessels, and lungs,posing a significant risk of recurrence.Here, we report a case of recurrent thymic cancer treated with complete surgical resection, replacement of the innominate vein, superior vena cava formation, and iodine ion insertion.A 51-year-old male diagnosed with stage lllA malignant thymoma in November 2021, accompanied by lymph node metastasis,involving the peripheral left lung.The patient underwent six cycles of adjuvant immunotherapy with pembrolizumab and cisplatin plus etoposide, along with one course of radiotherapy postoperatively.Subsequently, the patient received regular immunotherapy and follow-up at our hospital. In October 2023,chest CT revealed tumor recurrence, with infiltration into the pericardium, bilateral innominate veins, superior vena cava, and brachiocephalic artery.Subsequently, the patient underwent a midline thoracotomy for extensive resection of recurrent thymic tumor,enlargement of pericardial resection, left innominate vein-to-right atrial artificial grafting,superior vena cava formation,and iodine-125radioisotope brachytherapy.Aggressive surgical intervention combined with adjuvant therapy is an essential treatment modality for locally advanced thymic cancer involving the superior vena cava and surrounding blood vessels.

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“…Таким образом, терапевтические подходы к лечению карциноида тимуса в настоящее время весьма ограниченны. В 1-й линии терапии, при распространенных дифференцированных опухолях, применяются платин-содержащие цитостатические препараты в различных комбинациях (цисплатин, карбоплатин, паклитаксел, темозоломид, капецитабин, этопозид) с частичным ответом в 29-38% случаев [14]. Имеются некоторые данные об эффективности пептид-рецепторной терапии с 177 Lu-DOTATATE, 212 Pb-DOTAMTATE, 177 LuDOTA-EB-TATE, 90 Y-DOTATATE при НЭО различных локализаций, однако опыт применения их в отношении НЭО тимуса ограничен.…”

Section: Discussionunclassified

“…В настоящее время идут клинические исследования препаратов в качестве 2-й линии терапии при прогрессировании после ХТ. Эверолимус продемонстрировал обнадеживающие результаты как в рандомизированных клинических исследованиях, так и в отдельных сообщениях с клиническими случаями [14][15][16], сейчас обсуждается в качестве кандидата для 1-й линии терапии пациентов с НЭО тимуса. Ингибиторы ангиогенеза, такие как сунитиниб и пазопаниб, привели к контролю заболевания в контексте НЭО в 85% случаев с достижением выживаемости без прогрессирования в 10 мес [17,18].…”

Section: Discussionunclassified

Neuroendocrine tumor of thymus with ectopic production of adrenocorticotropic hormone in a 13-year-old child. Case report, 5-year follow-up

Slashchuk,

Reinberg,

Bazarova

et al. 2024

J. Mod. Onco.

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Neuroendocrine tumors (NET) of the thymus are rare, usually aggressive, and prone to metastatic lesion. Ectopic adrenocorticotropic hormone (ACTH) secretion in thymic NET (TNEN) is associated with poor prognosis. Most of TNET express somatostatin receptors, it allows the use of somatostatin receptor scintigraphy (SRS) and SPECT/CT or PET/CT with 68Ga-labeled peptides for diagnosis and staging of the disease. Surgery (macroscopic-complete resection) is the mainstay treatment for TNET. Now, there are no unequivocal data in adjuvant therapy and its effectiveness. We present a case report of the pediatric patient with well differentiated atypical ACTH-producing thymic carcinoid. This localization was verified by whole body somatostatin receptor scintigraphy with 111In-DTPA-octreotide (Octreoscan). The patient proceeded with the surgical treatment followed by remission of hypercorticism without adjuvant chemotherapy. Tumor recurrence with redevelopment of ACTH-ectopic syndrome was detected after 67 months of observation.

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Continuing challenges of primary neuroendocrine tumours of the thymus: A concise review

Cited by 3 publications

References 103 publications

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Recurrent thymic carcinoma treated with anterior median thoracotomy, innominate vein replacement for superior vena cava, and iodide implantation: A case report and review of the literature

Neuroendocrine tumor of thymus with ectopic production of adrenocorticotropic hormone in a 13-year-old child. Case report, 5-year follow-up

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