Thymic neuroendocrine tumor (thymic carcinoid): A clinicopathologic study in 15 patients

Background. Thymic neuroendocrine tumor (carcinoid tumor) is rare, and prog nosis 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 g rade. Results. Ten (66.7%) of 15 patients were male. Lymph node metastases were i dentified in 9 (60%) of 15 patients at the time of resection. There were on e grade 1, nine grade 2, and five grade 3 tumors. Total resection was possi ble in 13 patients. Distant metastases developed in 10 (76.9%) of these 13 patients, although no local recurrence developed. Of these 10 patients, 6 d ied of distant metastases 5 to 25 months after the recurrence. Three patien ts 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 y ears. Conclusions. Thymic neuroendocrine tumor must be regarded as a malignant ne oplasm that is prone to metastasize to mediastinal lymph nodes and to dista nt sites, even after total excision. Neither T and N classification nor his tologic grade has been successful in predicting the outcome of a patient wi th this tumor. More aggressive management, including adjuvant therapies and reexcision of subsequent tumors, may result in increased survival. (C) 199 9 by The Society of Thoracic Surgeons.