Two Cases of Thymic Carcinoma in Childhood

Lee, Young Ah; Park, Jin Young; Jung, Hye Lim; Park, Moon Soo; Choi, Hyoung Soo; Yoo, Eun Sun; Ahn, Hyo Seop

Abstract

Thymic carcinoma is a malignant neoplasm arising from the thymic epithelium, and is known to be extremely uncommon in the pediatric population. The tumor is clinically highly aggressive with frequent local intrathoracic spread and extrathoracic metastases detected in the majority of patients at initial diagnosis and often shows minimal or no response to conventional chemotherapy. We experienced two pediatric patients with thymic carcinoma and treated with combined modality, including intensive chemotherapy. They are considered to be the first and second pediatric cases reported in Korea. One patient was a 12-year-old male presented with thymic carcinoma with metastases to the pleura, pericardium, adjacent lungs and diaphragm. After the resection of the primary tumor and surrounding invaded structures, he was treated with a combined chemotherapy, including cisplatin, doxorubicin, etoposide and cyclophosphamide, and he is still alive at 8 months of chemotherpy without any evidence of recurrence or progression. The other patient was a 9-year-old male with a tumor of thymic origin, occupying the entire right hemithorax with metastases to the pleura and lungs. He was diagnosed with squamous cell carcinoma of the thymus through open thoracotomy and biopsy. In this case, the primary tumor was unresectable due to extensive invasion to the surrounding structures. Thus the patient was put on a combined chemotherpy, including cisplatin, doxorubicin and cyclophosphamide, but he showed little response and died of tumor progression after 9 months of chemotherapy.