An operated case of locally advanced thymic atypical carcinoid in anterior mediastinum: a case report

Primary thymic atypical carcinoid (TAC) is a kind of neuroendocrine tumors of the mediastinum, which has a poor prognosis due to its invasive behavior, metastasis and postoperative recurrence. We present a relatively rare case who came to hospital because of chest pain and tightness from a large mediastinal mass of 115 mm x 95 mm compressing left brachiocephalic veins, pericardium and upper-lobe of left lung. Although the operation was rather challenging, we performed complete resection including local lymph node dissection by open median stemotomy. The pathology of combining hematoxylin/eosin staining and immunohistochemical was confirmed to be primary TAC, grade 2 according to 2015 WHO Classification of Tumors of the Thymus. After radical surgery, the case underwent 6 cycles of platinum-based adjuvant chemotherapy. To date, the man has survived over 11 months without recurrence and distant metastasis. In conclusion, open surgery is a safe and effective method for locally advanced TAC and radical resection combination with adjuvant chemotherapy may lead to a long-term survival.