Difficulties in diagnosis and treatment of thymic adenocarcinoma producing β-human chorionic gonadotropin in anterior mediastinum

Abstract

A 68-year-old man with dyspnea and chest pain on left anterior chest during inspiration visited our hospital. An anterior mediastinal mass was detected on a chest computed tomography (CT) and we considered performing surgical treatment. Since the beta-human chorionic gonadotropin (beta-hCG) level was increased to 20.46 mIU/ml on the preoperative blood test, incisional biopsy was performed through a Chamberlain incision to rule out the mediastinal germ cell tumors. After diagnosing a benign mass on the postoperative pathological examination of the incisional biopsy specimen, total thymectomy that included the mass was performed via a full sternotomy. On the pathological examination after the second operation, the tumor was diagnosed as thymic adenocarcinoma producing beta-hCG, and the tumor had originated from the thymus.

Primary adenocarcinoma of the thymus: an immunohistochemical and molecular study with review of the literature

“…CEA in 23% (mostly seen in mucinous subtype), B-HCG in 0.38% (only in conventional subtype) and CA19-9 in 11% (one papillary, one NOS and two mucinous subtypes, including ours). Immunohistochemistry on different subtypes were performed in a limited number of papers and showed positivity in CK7 (7/11), CK20 (6/9), CEA (6/9), Leu M1 (4/5), B-HCG (1/2), CDX-2 (3/4), Muc2 (1/2), Muc5 (2/2), CD5 (8/12), P63 (1/2), CA-19-9 (3/3), CAM5.2 (2/2), CK5,6 (1/2), P53 (2/2), Her2 (1/2) [4-7,9-18]. …”

Endotracheal stent increased survival length in patients with invasive thymic adenocarcinoma

“…Thymic adenocarcinoma is extraordinarily rare neoplasm with only a few case reports in the literature. [ 1 2 3 ] Standard therapy regimens for thymic carcinomas include surgery, radiotherapy, and chemotherapy. [ 4 ] There are only two reports in the literature based on radiotherapy alone with poor outcomes.…”