A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report
Abstract Background An alpha-fetoprotein (AFP)-positive neuroendocrine tumor of the thymus is a rare thoracic malignancy. Few cases of AFP-positive thymic large cell neuroendocrine carcinoma have been reported, with no known previous report of an AFP-positive thymic small cell carcinoma. We encounte...
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Japan Surgical Society
2023-09-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-023-01750-4 |
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| author | Masao Kobayashi Soichiro Funaki Eriko Fukui Eiichi Morii Yasushi Shintani |
| author_facet | Masao Kobayashi Soichiro Funaki Eriko Fukui Eiichi Morii Yasushi Shintani |
| author_sort | Masao Kobayashi |
| collection | DOAJ |
| description | Abstract Background An alpha-fetoprotein (AFP)-positive neuroendocrine tumor of the thymus is a rare thoracic malignancy. Few cases of AFP-positive thymic large cell neuroendocrine carcinoma have been reported, with no known previous report of an AFP-positive thymic small cell carcinoma. We encountered a patient with an AFP-positive small cell carcinoma and report here the clinical course. Case presentation A 40-year-old man was transferred to our hospital for a large anterior mediastinal tumor and showed an elevated serum AFP level. Computed tomography-guided biopsy results led to diagnosis of small cell carcinoma. Induction chemoradiotherapy was performed before surgery because of pulmonary artery invasion. The response to Induction chemoradiotherapy varied among sites, with the main tumor showing shrinkage and the metastasis site growth. This discrepancy suggested a histologic type unresponsive to or cancer cells potentially resistant to chemotherapy, thus a surgical re-biopsy was performed and histological findings revealed AFP-positive small cell carcinoma. Additional chemotherapy was performed, though could not control cancer progression, and the patient died 8 months after the first medical examination. Conclusions Our present clinical experience indicates the importance of histological examination for determining AFP-positive anterior mediastinal tumor treatment. Although AFP-positive neuroendocrine tumor of the thymus is relatively rarer than germ cell carcinoma, differential diagnosis with use of a histological examination should be considered because of the potentially poorer prognosis. The present clinical findings for an AFP-positive neuroendocrine tumor of the thymus case are considered useful for establishing an optimal treatment strategy in the future. |
| format | Article |
| id | doaj-art-04cc8acf85974dd3aeeffc2cc41aee69 |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2023-09-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-04cc8acf85974dd3aeeffc2cc41aee692025-08-20T03:29:31ZengJapan Surgical SocietySurgical Case Reports2198-77932023-09-01911510.1186/s40792-023-01750-4A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case reportMasao Kobayashi0Soichiro Funaki1Eriko Fukui2Eiichi Morii3Yasushi Shintani4Department of General Thoracic Surgery, Osaka University Graduate School of MedicineDepartment of General Thoracic Surgery, Osaka University Graduate School of MedicineDepartment of General Thoracic Surgery, Osaka University Graduate School of MedicineDepartment of Pathology, Osaka University Graduate School of MedicineDepartment of General Thoracic Surgery, Osaka University Graduate School of MedicineAbstract Background An alpha-fetoprotein (AFP)-positive neuroendocrine tumor of the thymus is a rare thoracic malignancy. Few cases of AFP-positive thymic large cell neuroendocrine carcinoma have been reported, with no known previous report of an AFP-positive thymic small cell carcinoma. We encountered a patient with an AFP-positive small cell carcinoma and report here the clinical course. Case presentation A 40-year-old man was transferred to our hospital for a large anterior mediastinal tumor and showed an elevated serum AFP level. Computed tomography-guided biopsy results led to diagnosis of small cell carcinoma. Induction chemoradiotherapy was performed before surgery because of pulmonary artery invasion. The response to Induction chemoradiotherapy varied among sites, with the main tumor showing shrinkage and the metastasis site growth. This discrepancy suggested a histologic type unresponsive to or cancer cells potentially resistant to chemotherapy, thus a surgical re-biopsy was performed and histological findings revealed AFP-positive small cell carcinoma. Additional chemotherapy was performed, though could not control cancer progression, and the patient died 8 months after the first medical examination. Conclusions Our present clinical experience indicates the importance of histological examination for determining AFP-positive anterior mediastinal tumor treatment. Although AFP-positive neuroendocrine tumor of the thymus is relatively rarer than germ cell carcinoma, differential diagnosis with use of a histological examination should be considered because of the potentially poorer prognosis. The present clinical findings for an AFP-positive neuroendocrine tumor of the thymus case are considered useful for establishing an optimal treatment strategy in the future.https://doi.org/10.1186/s40792-023-01750-4Thymic carcinomaNeuroendocrine tumor of thymusAlpha-fetoprotein-producing thymic small cell carcinomaGerm cell tumor |
| spellingShingle | Masao Kobayashi Soichiro Funaki Eriko Fukui Eiichi Morii Yasushi Shintani A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report Surgical Case Reports Thymic carcinoma Neuroendocrine tumor of thymus Alpha-fetoprotein-producing thymic small cell carcinoma Germ cell tumor |
| title | A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report |
| title_full | A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report |
| title_fullStr | A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report |
| title_full_unstemmed | A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report |
| title_short | A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report |
| title_sort | case of alpha fetoprotein positive thymic small cell carcinoma a case report |
| topic | Thymic carcinoma Neuroendocrine tumor of thymus Alpha-fetoprotein-producing thymic small cell carcinoma Germ cell tumor |
| url | https://doi.org/10.1186/s40792-023-01750-4 |
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