Neuroendocrine tumors of the thymus and mediastinum

Bohnenberger, Hanibal; Dinter, Helen; König, Alexander; Ströbel, Philipp

doi:10.21037/jtd.2017.02.02

Cited by 40 publications

(48 citation statements)

References 57 publications

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“…Although there is no standard combination regimen, currently, chemotherapy is still recommended for TAC with high proliferation rates. Studies showed that cisplatin or temozolomide‐based chemotherapy regimens affect thymic neuroendocrine tumors . Platinum‐containing protocols, such as cisplatin and etoposide or carboplatin and etoposide, are recommended for patients diagnosed with TAC.…”

Section: Discussionmentioning

confidence: 99%

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Capecitabine and Temozolomide as a Promising Therapy for Advanced Thymic Atypical Carcinoid

Wang

Duan

et al. 2018

The Oncologist

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Background Thymic atypical carcinoid (TAC) is a rare thymic neuroendocrine tumor that originates in the neuroendocrine system and lacks a standardized treatment. The combination of capecitabine (CAP) and temozolomide (TEM) is associated with an extremely high and long‐lasting response rate in patients with metastatic pancreatic neuroendocrine tumors. However, there is little evidence showing that the CAPTEM regimen is effective for TAC. For patients with unresectable or metastatic atypical carcinoid of the thymus, few treatment options are available, and the treatment efficacy is not satisfactory. To explore the efficacy and safety of the CAPTEM regimen against TAC, we conducted a retrospective review. Patients and Methods A total of nine patients with advanced atypical carcinoid of the thymus in the China‐Japan Friendship Hospital were treated with capecitabine (750 mg/m2 twice daily, days 1–14) and temozolomide (200 mg/m2 once daily, days 10–14) every 28 days between 2014 and 2018. The disease control rate (DCR), progression‐free survival (PFS), and adverse effects after treatment were analyzed. The DCR was calculated by RECIST version 1.1. Progression‐free survival was calculated by the Kaplan‐Meier survival method. Results A total of nine patients (six male and three female) were included. The median age at CAPTEM initiation was 50 years (range, 26–58). The median number of CAPTEM cycles was 8 (range, 3–23). The DCR was 89% (8/9), with eight patients achieving stable disease. Only one patient (11%) showed progressive disease. The median PFS was 8 months. Because we applied vitamin B6 and ondansetron before administering the drugs, the side effects of this regimen were very small. Adverse reactions were all below grade 3 and included myelosuppression and digestive tract reaction. Conclusion Our results suggest that the CAPTEM regimen may be effective and well tolerated for the treatment of TAC. More evidence is needed to validate the effectiveness of this regimen. Implications for Practice Capecitabine and temozolomide regimen is effective and well tolerated in patients with advanced thymic atypical carcinoid.

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Section: Discussionmentioning

confidence: 99%

“…They only account for approximately 2% to 5% of thymic carcinomas . Thymic atypical carcinoid (TAC) accounts for approximately 40%–50% of all thymic neuroendocrine tumors . Because of the rareness of this disease, there is a lack of standard treatment options, and few reports related to TAC have been published.…”

Section: Introductionmentioning

confidence: 99%

Capecitabine and Temozolomide as a Promising Therapy for Advanced Thymic Atypical Carcinoid

Wang

Duan

et al. 2018

The Oncologist

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“…Chief among the tumors to be tested are lung, ovarian, and breast carcinomas, as well as mediastinal tumors, such as neuroendocrine carcinomas and thymoma. (4) Myasthenia gravis is the most common form of thymoma-related paraneoplastic neurological syndrome.…”

Section: To the Editormentioning

confidence: 99%

Gastric pseudo-obstruction as an initial manifestation of thymoma

et al. 2019

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TO THE EDITOR:Thymomas and thymic carcinomas are rare, accounting for 20% of all mediastinal tumors. They are usually diagnosed as incidental findings on chest imaging performed for another reason or performed because of the presence of mass effect-related symptoms or paraneoplastic syndrome, such as myasthenia gravis. They have similar incidence in men and women and most commonly occur in the 40-to 60-year age group. There are no risk factors. (1,2) We would like to present the case of a 79-year-old female patient who presented to our facility with a two-month history of weight loss and constipation. She was admitted to the hospital with signs of intestinal obstruction, abdominal bloating, and vomiting. A nasogastric tube drained 3,000 mL of stool-like secretion. Abdominal X-ray and ultrasound revealed a dilated stomach with an air-fluid level ( Figures 1A and 1B). Upper gastrointestinal endoscopy revealed no points of mechanical obstruction; there was erosive reflux esophagitis, exuberant gastric dilatation associated with gastric stasis, and hypertrophic pyloric stenosis. Serology for Chagas disease was negative.The assessment continued with abdominal CT, which showed no evidence of any obstructive factor or tumor, and chest CT, which identified a well-demarcated anterior mediastinal mass with a maximum diameter of approximately 5 cm and no invasion of adjacent structures ( Figure 1C). Given the possibility of paraneoplastic syndrome, video-assisted thoracoscopic resection was performed, and pathological examination showed small cell neoplasm of uncertain malignant histogenesis and immunohistochemistry, confirming the diagnosis of type B1 thymoma.Following tumor resection, the patient experienced a lower frequency of vomiting and was able to tolerate the diet. Gastrography was performed which showed contrast progression and a normal-sized stomach with peristalsis ( Figure 1D). A second endoscopy revealed a normal stomach with strong peristaltic waves and no sign of previous hypertrophic pyloric stenosis. The patient was discharged on an oral diet. Serum antibody testing for myasthenia gravis and paraneoplastic syndrome was ordered.Gastroparesis consists of delayed gastric emptying of solids in the absence of mechanical obstruction. The A B C D Figure 1. In A and B, abdominal X-ray showing gastric bloating. In C, CT scan showing a well-demarcated anterior mediastinal tumor. In D, gastrography showing normal gastric emptying.

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“…Mediastinal tumor is a common chest tumor. Mediastinum, an area defined by anatomy (1), contains all organs and tissues of the chest from the sternum to the spine and between the lungs. These organs and tissues are derived from different viviparous tissues, so there is no specific pathogenic factor and obvious disease zone of a high incidence in mediastinal tumor.…”

Section: Introductionmentioning

confidence: 99%

Effect of video‑assisted thoracoscopic surgery on pain stress indicators NO, IL‑1β and IL‑6 in the treatment of mediastinal tumor in children

et al. 2020

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This study aimed to investigate the effect of video-assisted thoracoscopic surgery (VATS) on pain stress indicators nitric oxide (NO), interleukin-1β (IL-1β) and IL-6 in the treatment of mediastinal tumor in children, so as to explore the clinical application value of this surgery. A retrospective analysis was performed on 82 children with mediastinal tumor undergoing operation in Children's Hospital Affiliated to Zhengzhou University from January 2012 to January 2016. Among them, 48 children undergoing VATS were enrolled as an observation group, and 34 children undergoing conventional thoracotomy were enrolled as a control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the preoperative and postoperative expression levels of NO, IL-1β and IL-6. The intraoperative clinical data, postoperative pain degree and infection rate were observed and recorded in real time, and then compared between the two groups. Before operation (T 0), there were no statistically significant differences between the two groups in serum NO, IL-1β and IL-6 expression levels, which were lower in the observation group than those in the control group at 12 h (T 1) and 24 h (T 2) after operation (P<0.05). The visual analog scale (VAS) score in the observation group was lower than that in the control group at T 1 (P<0.05). Compared with the control group, the largest blade opening, intraoperative blood loss, drainage duration and postoperative pain degree were significantly improved in the observation group. The postoperative infection rate was 4.17% in the observation group, significantly lower than 17.64% in the control group. VATS is effective for postoperative pain stress indicators and infection control in children with mediastinal tumor, which is therefore more suitable for children with the disease and has a higher clinical value.

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Neuroendocrine tumors of the thymus and mediastinum

Cited by 40 publications

References 57 publications

Capecitabine and Temozolomide as a Promising Therapy for Advanced Thymic Atypical Carcinoid

Capecitabine and Temozolomide as a Promising Therapy for Advanced Thymic Atypical Carcinoid

Gastric pseudo-obstruction as an initial manifestation of thymoma

Effect of video‑assisted thoracoscopic surgery on pain stress indicators NO, IL‑1β and IL‑6 in the treatment of mediastinal tumor in children

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