ABSTRACT

Thymic carcinoma is a rare neoplasm originating in the thymic epithelium. In 2004, WHO classified it as a group C thymus tumour. Its high degree of malignancy and the few early symptoms it presents. At the time it is diagnosed, resection is difficult and prognosis is poor. We reviewed the background of the last four cases in our department treated with neoadjuvant chemotherapy (CT), followed by surgery and adjuvant treatment.
Material and methods: A retrospective review was made, we present the files of 4 patients with histological confirmation of thymic carcinoma treated with neoadjuvant chemotherapy, surgery and adjuvant treatment between October 1999 and October 2005. The diagnostic biopsy was performed by mediastinoscopy, mediastinotomy or Percutaneous Fine Needle Aspiration (FNA) by fibrobronchoscopy, with the corresponding staining and immunohistochemistry tests being carried out. The therapeutic approach was decided by a multidisciplinary team and involved preoperative CT, after which clinical restaging and surgery were performed, adjusting adjuvant treatment according to each case.
Resection was performed by median sternotomy or by right thoracotomy in one case.
Results: The symptoms shown by the patients in our series were; vena cava syndrome, chest pain and dyspnea. The anatomical pathology confirmed 2 cases of typical thymic carcinoma, 1 of large cells and 1 lymphoepithelial, with complete remission of tumour in two cases after the CT.
Is over all survival of our cases was 44 months, with 2 local recurrences, 1 distal recurrence and 1 patient free of disease.
Conclusion: We believe that neoadjuvant treatment for type C thymic tumours, Masoka Stages III and IV requires a therapeutic approach based on neoadjuvant CT, which facilitates surgical resection and neoadjuvant treatment adjusted to each case.

KEYWORDS

Thymic carcinoma, neoadjuvant chemotherapy.

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