Thymic Adenocarcinoma with Positivity for Thyroid Transcription Factor-1 and a BRAF V600E Mutation

Overview

Journal Intern Med

Specialty General Medicine

Date 2021 Jul 19

PMID 34275983

Authors

Takafumi Yorozuya

Mitsuo Otsuka

Shin Ichihara

Kento Fujimori

Chikako Kitamura

Tomoyuki Takahashi

Masaki Mori

Yasushi Cho

Hirofumi Chiba

Affiliations

Soon will be listed here.

Abstract

Thymic adenocarcinomas are rare. We herein report for the first time a case of thymic adenocarcinoma with positivity for thyroid transcription factor-1 (TTF-1) and a BRAF V600E mutation. A 50-year-old woman had persistent suffocation and chest pain. Computed tomography revealed a 42×28-mm tumor in the anterior mediastinum. The patient underwent tumor resection using video-assisted thoracoscopic surgery. Histopathological findings showed thymic papillary adenocarcinoma, Masaoka stage II. Immunohistochemically, the tumor was positive for TTF-1. A sequencing analysis revealed a BRAF V600E mutation. The patient underwent postoperative radiotherapy and was in good health without recurrence at five months after resection.

References

Gbolahan O, Porter R, Salter J, Yiannoutsos C, Burns M, Chiorean E . A Phase II Study of Pemetrexed in Patients with Recurrent Thymoma and Thymic Carcinoma. J Thorac Oncol. 2018; 13(12):1940-1948. DOI: 10.1016/j.jtho.2018.07.094. View

Kawasaki H, Arakaki K, Taira N, Furugen T, Ichi T, Yohena T . Lung Cancer Detected 5 Years after Resection of Cancer of Unknown Primary in a Mediastinal Lymph Node: A Case Report and Review of Relevant Cases from the Literature. Ann Thorac Cardiovasc Surg. 2015; 22(2):116-21. PMC: 4936212. DOI: 10.5761/atcs.cr.15-00154. View

Conforti F, Tarantino P, Trillo P, Pala L, Zagami P, Pirola S . Pathological and clinical features of enteric adenocarcinoma of the thymus. A pooled analysis of cases from a reference center and systematic review of the literature. Cancer Treat Rev. 2020; 92:102133. DOI: 10.1016/j.ctrv.2020.102133. View

Hirai F, Yamanaka T, Taguchi K, Daga H, Ono A, Tanaka K . A multicenter phase II study of carboplatin and paclitaxel for advanced thymic carcinoma: WJOG4207L. Ann Oncol. 2014; 26(2):363-8. DOI: 10.1093/annonc/mdu541. View

Tiacci E, Trifonov V, Schiavoni G, Holmes A, Kern W, Martelli M . BRAF mutations in hairy-cell leukemia. N Engl J Med. 2011; 364(24):2305-15. PMC: 3689585. DOI: 10.1056/NEJMoa1014209. View

Lemma G, Lee J, Aisner S, Langer C, Tester W, Johnson D . Phase II study of carboplatin and paclitaxel in advanced thymoma and thymic carcinoma. J Clin Oncol. 2011; 29(15):2060-5. PMC: 3107762. DOI: 10.1200/JCO.2010.32.9607. View

Girard N, Ruffini E, Marx A, Faivre-Finn C, Peters S . Thymic epithelial tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015; 26 Suppl 5:v40-55. DOI: 10.1093/annonc/mdv277. View

Matoso A, Singh K, Jacob R, Greaves W, Tavares R, Noble L . Comparison of thyroid transcription factor-1 expression by 2 monoclonal antibodies in pulmonary and nonpulmonary primary tumors. Appl Immunohistochem Mol Morphol. 2009; 18(2):142-9. PMC: 2828524. DOI: 10.1097/PAI.0b013e3181bdf4e7. View

Travis W, Brambilla E, Burke A, Marx A, Nicholson A . Introduction to The 2015 World Health Organization Classification of Tumors of the Lung, Pleura, Thymus, and Heart. J Thorac Oncol. 2015; 10(9):1240-1242. DOI: 10.1097/JTO.0000000000000663. View

10.

Holderfield M, Deuker M, McCormick F, McMahon M . Targeting RAF kinases for cancer therapy: BRAF-mutated melanoma and beyond. Nat Rev Cancer. 2014; 14(7):455-67. PMC: 4250230. DOI: 10.1038/nrc3760. View

11.

Ruffini E, Detterbeck F, Van Raemdonck D, Rocco G, Thomas P, Weder W . Tumours of the thymus: a cohort study of prognostic factors from the European Society of Thoracic Surgeons database. Eur J Cardiothorac Surg. 2014; 46(3):361-8. PMC: 4155438. DOI: 10.1093/ejcts/ezt649. View

12.

Jackson M, Palma D, Camidge D, Jones B, Robin T, Sher D . The Impact of Postoperative Radiotherapy for Thymoma and Thymic Carcinoma. J Thorac Oncol. 2017; 12(4):734-744. DOI: 10.1016/j.jtho.2017.01.002. View

13.

Koizumi T, Otsuki K, Tanaka Y, Noguchi T, Fukushuima T, Kobayashi T . National incidence and initial therapy for thymic carcinoma in Japan: based on analysis of hospital-based cancer registry data, 2009-2015. Jpn J Clin Oncol. 2020; 50(4):434-439. DOI: 10.1093/jjco/hyz203. View

14.

Lim Y, Song C, Kim J . Improved survival with postoperative radiotherapy in thymic carcinoma: A propensity-matched analysis of Surveillance, Epidemiology, and End Results (SEER) database. Lung Cancer. 2017; 108:161-167. DOI: 10.1016/j.lungcan.2017.03.020. View

15.

Lee M, Choi S, Yoon Y, Kim J, Baek W, Kim Y . Metastatic Thymic Adenocarcinoma from Colorectal Cancer. Korean J Thorac Cardiovasc Surg. 2015; 48(6):447-51. PMC: 4672987. DOI: 10.5090/kjtcs.2015.48.6.447. View

16.

Prahallad A, Sun C, Huang S, Di Nicolantonio F, Salazar R, Zecchin D . Unresponsiveness of colon cancer to BRAF(V600E) inhibition through feedback activation of EGFR. Nature. 2012; 483(7387):100-3. DOI: 10.1038/nature10868. View

17.

Varadhachary G, Raber M . Cancer of unknown primary site. N Engl J Med. 2014; 371(8):757-65. DOI: 10.1056/NEJMra1303917. View

18.

Kalhor N, Moran C . Primary thymic adenocarcinomas: a clinicopathological and immunohistochemical study of 16 cases with emphasis on the morphological spectrum of differentiation. Hum Pathol. 2018; 74:73-82. DOI: 10.1016/j.humpath.2018.01.011. View

19.

Giaccone G, Kim C, Thompson J, McGuire C, Kallakury B, Chahine J . Pembrolizumab in patients with thymic carcinoma: a single-arm, single-centre, phase 2 study. Lancet Oncol. 2018; 19(3):347-355. PMC: 10683856. DOI: 10.1016/S1470-2045(18)30062-7. View

20.

de Jong W, Blaauwgeers J, Schaapveld M, Timens W, Klinkenberg T, Groen H . Thymic epithelial tumours: a population-based study of the incidence, diagnostic procedures and therapy. Eur J Cancer. 2007; 44(1):123-30. DOI: 10.1016/j.ejca.2007.11.004. View