Pigmented spindle cell variant of a thymic atypical carcinoid in an octogenarian.

Atypical carcinoid Pigmented carcinoid Spindle cell carcinoid Thymic carcinoid Thymic neuroendocrine tumor

Journal

Surgical case reports
ISSN: 2198-7793
Titre abrégé: Surg Case Rep
Pays: Germany
ID NLM: 101662125

Informations de publication

Date de publication:
06 Jan 2021
Historique:
received: 27 10 2020
accepted: 09 12 2020
entrez: 7 1 2021
pubmed: 8 1 2021
medline: 8 1 2021
Statut: epublish

Résumé

A pigmented carcinoid is an extremely rare variant of carcinoid characterized by melanin pigmentation of the tumor, with only five cases described in the literature. In addition, thymic carcinoids are rare in elderly patients and their prognosis after resection of the carcinoid tumor is unclear. An anterior mediastinal tumor was incidentally found in an 82-year-old man who had been diagnosed with acute thoracic empyema. The tumor was considered most likely to be a noninvasive thymoma or thymic carcinoma for which surgery was indicated after the resolution of the empyema. The tumor was completely resected 4 months after the empyema surgery, and the patient had an uneventful postoperative course. A cut surface of the resected specimen was extensively pigmented and appeared dark-brownish, with abundant melanin pigmentation later confirmed in the spindle-shaped tumor cells. Based on the histologic examination and immunohistochemical study, melanoma was eliminated as a differential diagnosis and the tumor was diagnosed as a pigmented atypical carcinoid of the thymus. This report provides additional knowledge on thymic pigmented carcinoids and thymic atypical carcinoids in elderly patients.

Sections du résumé

BACKGROUND BACKGROUND
A pigmented carcinoid is an extremely rare variant of carcinoid characterized by melanin pigmentation of the tumor, with only five cases described in the literature. In addition, thymic carcinoids are rare in elderly patients and their prognosis after resection of the carcinoid tumor is unclear.
CASE PRESENTATION METHODS
An anterior mediastinal tumor was incidentally found in an 82-year-old man who had been diagnosed with acute thoracic empyema. The tumor was considered most likely to be a noninvasive thymoma or thymic carcinoma for which surgery was indicated after the resolution of the empyema. The tumor was completely resected 4 months after the empyema surgery, and the patient had an uneventful postoperative course. A cut surface of the resected specimen was extensively pigmented and appeared dark-brownish, with abundant melanin pigmentation later confirmed in the spindle-shaped tumor cells. Based on the histologic examination and immunohistochemical study, melanoma was eliminated as a differential diagnosis and the tumor was diagnosed as a pigmented atypical carcinoid of the thymus.
CONCLUSIONS CONCLUSIONS
This report provides additional knowledge on thymic pigmented carcinoids and thymic atypical carcinoids in elderly patients.

Identifiants

pubmed: 33409736
doi: 10.1186/s40792-020-01094-3
pii: 10.1186/s40792-020-01094-3
pmc: PMC7788128
doi:

Types de publication

Journal Article

Langues

eng

Pagination

12

Références

Histopathology. 2002 Feb;40(2):159-65
pubmed: 11952860
J Clin Oncol. 2008 Jun 20;26(18):3063-72
pubmed: 18565894
Interact Cardiovasc Thorac Surg. 2018 Jan 1;26(1):18-24
pubmed: 29049806
Cancer. 1972 Apr;29(4):1061-74
pubmed: 4111691
Cancer. 1987 Feb 1;59(3):484-8
pubmed: 3024805
Genes Chromosomes Cancer. 2014 Sep;53(9):738-49
pubmed: 24764238
Histopathology. 2007 Aug;51(2):263-5
pubmed: 17593208
J Thorac Cardiovasc Surg. 2015 Jan;149(1):103-9.e2
pubmed: 25308116
Histopathology. 1977 Sep;1(5):363-9
pubmed: 615841
Ann Thorac Surg. 2012 Jul;94(1):241-5; discussion 245-6
pubmed: 22632882
Ann Surg. 2010 Jun;251(6):1117-21
pubmed: 20485130
J Thorac Oncol. 2015 Sep;10(9):1240-1242
pubmed: 26291007
Mod Pathol. 1999 Oct;12(10):946-8
pubmed: 10530558

Auteurs

Yasushi Sakamaki (Y)

Department of Chest Surgery, Osaka Police Hospital, Kitayamacho 10-31, Tennoji, Osaka, 543-0035, Japan. sak@serenade.plala.or.jp.

Ryo Tanaka (R)

Department of Chest Surgery, Osaka Police Hospital, Kitayamacho 10-31, Tennoji, Osaka, 543-0035, Japan.

Daisuke Ishida (D)

Department of Chest Surgery, Osaka Police Hospital, Kitayamacho 10-31, Tennoji, Osaka, 543-0035, Japan.

Hiromi Tsuji (H)

Department of Diagnostic Pathology, Osaka Police Hospital, Osaka, Japan.

Asako Mike (A)

Department of Diagnostic Pathology, Osaka Police Hospital, Osaka, Japan.

Hironao Yasuoka (H)

Department of Diagnostic Pathology, Osaka Police Hospital, Osaka, Japan.

Classifications MeSH