Thymic adenocarcinoma presenting as an incidental mediastinal mass

J Cardiothorac Surg. 2022 Oct 6;17(1):257. doi: 10.1186/s13019-022-02000-8.

Abstract

Background: Primary thymic adenocarcinoma represents an exceptionally rare malignancy, for which the cornerstone of therapy is margin-negative resection, with radiation and systemic therapy reserved for invasive and advanced disease. Thymic adenocarcinoma has not been previously reported in the setting of a concomitant malignancy, as reported herein.

Case presentation: We present a case of a 55-year-old previously healthy male diagnosed with acute myeloid leukemia, also found to have a mediastinal mass. Evaluation of the mediastinal mass with tumor markers, biopsies, and next-generation sequencing proved non-diagnostic, while he was simultaneously treated with induction chemotherapy to prevent leukemia-related blast crisis. After completing and recovering from induction chemotherapy, he underwent successful thymectomy during a chemotherapy holiday, with a margin-negative resection of thymic adenocarcinoma. He has subsequently recovered and undergone successful allogeneic hematopoietic stem cell transplant.

Conclusions: We present a case of synchronous adult acute myeloid leukemia and primary thymic adenocarcinoma requiring a tailored approach for management of simultaneous malignancies.

Keywords: Acute myeloid leukemia; Thymectomy; Thymic adenocarcinoma; Thymus.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma* / diagnosis
  • Adenocarcinoma* / pathology
  • Adenocarcinoma* / therapy
  • Adult
  • Biomarkers, Tumor
  • Humans
  • Leukemia, Myeloid, Acute*
  • Male
  • Middle Aged
  • Thymectomy
  • Thymoma* / diagnosis
  • Thymoma* / therapy
  • Thymus Neoplasms* / diagnosis
  • Thymus Neoplasms* / pathology
  • Thymus Neoplasms* / therapy

Substances

  • Biomarkers, Tumor