Successful treatment with concurrent chemoradiotherapy followed by surgeryfor a patient with thymic adenocarcinoma

Most neoplasms arising from the thymic epithelium are considered to be 'thy momas,' which are composed of cytologically benign, neoplastic epithelial c ells and nonneoplastic lymphocytes. In contrast, thymic epithelial neoplasm s displaying cytologically malignant features have recently been classified as thymic carcinomas of various types of histology (1-6). However, primary thymic adenocarcinoma is extremely rare and only four cases of it have bee n reported in the literature (7). We report a rare case of primary thymic a denocarcinoma of 4-year complete remission with concurrent chemoradiotherap y followed by surgery. A 61-year-old Japanese man was referred to us compla ining of facial edema and general fatigue. Computed tomography scans reveal ed a huge mass in the anterior mediastinum obstructing the superior vena ca va. He was diagnosed with thymic adenocarcinoma on needle biopsy. He was tr eated with induction chemoradiotherapy consisting of cisplatin, 5-FU and co ncurrent thoracic radiation, which yielded a partial response. He then unde rwent surgical resection of the remaining mass. However, pathologic examina tion of the resected mass revealed no malignant cells. The patient is doing well without symptoms or signs of relapse 53 months after diagnosis.