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Ann Thorac Surg 1999;67:208-211
© 1999 The Society of Thoracic Surgeons
a Department of Surgery II, Nagoya City University Medical School, Nagoya, Japan
b Department of Pathology II, Nagoya City University Medical School, Nagoya, Japan
Accepted for publication June 18, 1998.
Address reprint requests to Dr Fukai, Department of Surgery II, Nagoya City University Medical School, Mizuho-ku, Nagoya, 467-8601, Japan
e-mail: i.fukai{at}med.nagoya-cu.ac.jp
Background. Thymic neuroendocrine tumor (carcinoid tumor) is rare, and prognosis for patients with this tumor has been difficult to predict.
Methods. The medical records of 15 patients were reviewed, and the patients were classified according to tentative TNM classification and histologic grade.
Results. Ten (66.7%) of 15 patients were male. Lymph node metastases were identified in 9 (60%) of 15 patients at the time of resection. There were one grade 1, nine grade 2, and five grade 3 tumors. Total resection was possible in 13 patients. Distant metastases developed in 10 (76.9%) of these 13 patients, although no local recurrence developed. Of these 10 patients, 6 died of distant metastases 5 to 25 months after the recurrence. Three patients are still alive, with metastases to the bone, spleen, and pleura 1 to 24 months after the diagnosis of recurrence. Two patients are presently tumor free (T1N0, grade 3 and T3N2, grade 2), but only 1 has survived beyond 5 years.
Conclusions. Thymic neuroendocrine tumor must be regarded as a malignant neoplasm that is prone to metastasize to mediastinal lymph nodes and to distant sites, even after total excision. Neither T and N classification nor histologic grade has been successful in predicting the outcome of a patient with this tumor. More aggressive management, including adjuvant therapies and reexcision of subsequent tumors, may result in increased survival.
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