Abstract:
:We report a very rare case of combined thymic carcinomas: undifferentiated thymic carcinoma coexisting with type AB thymoma. The precise mechanism underlying the coexistence of these tumors remains unknown. Therefore, we used clonality analysis to ascertain whether the two tumors were clonally related. A 63-year-old woman with thyroid cancer visited our hospital. Chest computed tomography also revealed an anterior mediastinal tumor. The patient was treated with total thyroidectomy and surgery for mediastinal tumors together with left upper lobe partial resection. The mediastinal tumor was pathologically diagnosed as undifferentiated thymic carcinoma coexisting with type AB thymoma. Multiple pulmonary metastases were detected in the patient and stage IV disease was diagnosed. The tumor was treatment-resistant, and the patient received fourth-line chemotherapy. We conducted clonality analysis using an improved human androgen receptor gene-amplification assay that involves random X-chromosome inactivation through methylation, followed by methylated gene-specific PCR amplification after sample DNA digestion with HpaII, a methylation-sensitive restriction enzyme. Clonality analysis demonstrated identical X-chromosome inactivation in cells present in both thymoma and thymic carcinoma areas, and thus revealed clonal proliferation. The two lesions in the patient might have arisen through the transformation of a preexisting thymoma into a more malignant lesion.
journal_name
Pathol Intjournal_title
Pathology internationalauthors
Karino F,Yokose T,Matsukuma S,Miyagi Y,Murakami S,Ito H,Nakayama H,Yamada Kdoi
10.1111/pin.12426subject
Has Abstractpub_date
2016-07-01 00:00:00pages
398-403issue
7eissn
1320-5463issn
1440-1827journal_volume
66pub_type
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