[Thymoma and somatostatin analogs. Biology, diagnostic and clinical practice]

Thymic tumours are rare neoplasms which generally follow a slow pattern of growth, showing their aggressiveness locally through the infiltration of adjacent organs and they rarely metastasise hematogenically. In the presence of locally advanced, metastatic or inoperable disease, combined strategies including chemotherapy, radiotherapy and surgery are now being evaluated. Scintigraphy with 111In DTPA-D-Phe 1 octreotide was used for the first time in a relevant series of patients with thymic tumour (13 cases) by our research group. The presence of somatostatin receptors (ss-R) assayed in vivo provided the rationale for the use of a treatment based on the octreotide analog in a patient with thymoma and aplasia of the erythroid series (pure red cell aplasia, PRCA) in whom a complete response for the tumour and the remission of anemia was obtained. The efficacy of this treatment was confirmed by our series of patients with chemoresistant thymic tumour and by national and international confirmations. These data, ranging from in vivo diagnosis to treatment and the in vitro study of receptor expression, confirm that somatostatin plays a major role in thymic tumours.