American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2017, 5(12), 285-288
DOI: 10.12691/ajmcr-5-12-1
Open AccessCase Report

A Case of Distal Pancreatectomy for Pancreatic Metastasis of Thymic Atypical Carcinoid

Masashi Inoue1, , Masahiro Tanemura2, Toshimitsu Irei1, Yuyo Maeda1, Megumi Yamaguchi1, Tatsuya Miyamoto1, Shingo Seo1, Toshihiro Misumi1, Wataru Shimizu1, Takahisa Suzuki1, Takashi Onoe1, Takeshi Sudo1, Yosuke Shimizu1, Takao Hinoi1 and Hirotaka Tashiro1

1Department of surgery, Kure Medical Center Chugoku Cancer Center, Kure, Japan

2Department of Surgery, Osaka police Hospital, Osaka, Japan

Pub. Date: December 29, 2017

Cite this paper:
Masashi Inoue, Masahiro Tanemura, Toshimitsu Irei, Yuyo Maeda, Megumi Yamaguchi, Tatsuya Miyamoto, Shingo Seo, Toshihiro Misumi, Wataru Shimizu, Takahisa Suzuki, Takashi Onoe, Takeshi Sudo, Yosuke Shimizu, Takao Hinoi and Hirotaka Tashiro. A Case of Distal Pancreatectomy for Pancreatic Metastasis of Thymic Atypical Carcinoid. American Journal of Medical Case Reports. 2017; 5(12):285-288. doi: 10.12691/ajmcr-5-12-1

Abstract

Background: Thymic atypical carcinoid(AC) tends to have a more aggressive clinical course than typical carcinoid(TC). About 20%-30% of patients with thymic AC experience local recurrence or distant metastasis. Pancreatic metastasis of thymic AC is extremely infrequent. We experienced a case of pancreatic metastasis of thymic atypical carcinoid, in which a distal pancreatectomy was performed. Case presentation: A 50-year-old man underwent thoracoscopic resection of a mediastinal tumor in June 2009. The diagnosis was thymic AC. He also underwent an extended thymectomy in October 2011, thoracoscopic resection in October 2012, and tumor resection of the chest wall in March 2013 for recurrences. During follow up in April 2014, computed tomography (CT) revealed lymph node swelling on the ventral side of the brachiocephalic vein, around the left gastric vein, and on the left side of the celiac artery. Dynamic CT revealed a pancreatic tumor 10 mm in diameter with low enhancement. EUS-guided fine-needle aspiration (EUS-FNA) biopsy revealed the pancreatic tumor was compatible with metastasis of thymic AC. The patient underwent abdominal lymph node resection and distal pancreatectomy in June 2014. Because the lymph node on the ventral side of the branchiocephalic vein was judged as unresectable, 60-Gy radiation therapy was given in September 2014. Per pathological examination and immunohistochemistry, the final diagnosis was pancreatic metastasis of thymic AC. With several chemotherapy courses for recurrences, the patient has remained alive for eight years after the first surgery. Conclusion: AC metastasis to the pancreas is extremely rare. EUS-FNA is useful for diagnosis. Definitive determination of whether the treatment provides a survival benefit awaits further studies.

Keywords:
thymic atypical carcinoid pancreatic metastasis distal pancreatectomy

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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