An unusual combined thymic carcinoma composed of squamous cell carcinoma and type AB thymoma: a rare case report
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CASE REPORT
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An unusual combined thymic carcinoma composed of squamous cell carcinoma and type AB thymoma: a rare case report Yufeng Jiang1,2, Yang Liu1, Xiuying Shi1, Xiaoyun Mao3, Yang Zhao4 and Chuifeng Fan1*
Abstract Background: Combined thymic carcinoma is a malignant neoplasm of the thymus recently added to the 4th edition of the World Health Organization (WHO) classification of tumors of the lung, pleura, thymus and heart. It involves at least one type of thymic carcinoma and another thymic epithelial tumor. The previously used term “combined thymic epithelial tumor” has been abandoned. Case presentation: Here, we present an unusual case of combined thymic carcinoma of the thymus in a 44-yearold male who had suffered from fever, chest pain, chest tightness and shortness of breath. Magnetic resonance imaging (MRI) detected a mass approximately 6.4 cm × 4.2 cm in the anterior mediastinum, and a nonencapsulated tumor approximately 5.0 cm × 3.5 cm × 2.5 cm with an irregular shape was resected. The morphological features and the immunostaining pattern of the tumor revealed it to be an unusual combined thymic carcinoma consisting of type AB thymoma and squamous cell carcinoma. There were cysts of various sizes, some of which had crack-like structures, in the type AB thymoma area. A gradual transition could be seen between these structures and the squamous cell carcinoma, indicating that the carcinoma portion may have originated from the composition of the thymoma. Conclusions: Combined thymic carcinoma composed of type AB thymoma and squamous cell carcinoma is rare, and the carcinoma portion may have originated from epithelial structures in the type AB thymoma. Keywords: Combined thymic carcinoma, Mediastinum, Squamous cell carcinoma, Type AB thymoma
Background Combined thymic carcinomas are tumors composed of at least one type of thymic carcinoma and another thymic epithelial tumor of any type of thymoma or thymic carcinoma, excluding small cell carcinoma and large cell neuroendocrine carcinoma [1]. It was proposed that the previously recommended term “combined thymoma” be abandoned because thymomas of different histological types within the same tumor are very common, according to the 4th edition of the World Health Organization (WHO) classification of tumors of the lung, pleura, thymus and heart [1]. Instead, the WHO suggested that all the histological types present be listed in the diagnosis [1]. For * Correspondence: [email protected] 1 Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences of China Medical University, 110001 Shenyang, China Full list of author information is available at the end of the article
heterogeneous tumors that consist of a thymic carcinoma and a thymoma, the organization proposes the new term “combined thymic carcinoma.” The most common combinations are thymic squamous cell carcinoma and type B3 thymoma and papillary adenocarcinoma or sarcomatoid carcinoma associated with type A thymoma [1–4]. The different components of the tumors ma
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