[A giant invasive thymoma made resectable by cisplatin + vincristine + doxorubicin + etoposide (CODE)]

A 39-year-old man experienced cough and dyspnea by right massive pleural effusion. A large tumor was found in the anterior mediastinum and it had invaded the chest wall all around. The diagnosis was invasive thymoma stage IV a by biopsy. His tumor was too large to be resected, so chemotherapy was planned. The tumor responded well to cisplatin + etoposide until day 7, but it relapsed immediately between doses. Hence, we administered cisplatin + vincristine + doxorubicin + etoposide (CODE) with G-CSF for its high-dose intensity. The tumor diminished in size, and the chest wall invasion almost disappeared. An operation was performed. We describe our experience with a case of invasive thymoma which responded to CODE.