[A Case of Primary Thymic Carcinoid Treated with Everolimus and Octreotide]

A 54-year-old woman had a history of precordial pain since February 20XX and had undergone a clinical examination at a nearby medical clinic in April 20XX. Because a plain chest radiograph revealed a mass shadow, the patient was referred to us for medical evaluation. Chest computerized tomography(CT)revealed a mass measuring 12 cm in size along its major axis diameter in the anterior mediastinal region, along with the enlargement of the anterior mediastinal, parasternal, hilar, and supradiaphragmatic lymph nodes, suggesting a thymic tumor. Histopathological examination of a needle biopsy specimen revealed a carcinoid. Thus, the patient was diagnosed with a primary thymic carcinoid. The patient was treated by partial excision of the mediastinal tumor owing to the presence of pericardial dissemination. Because of the histopathologic diagnosis of atypical carcinoid, the patient was additionally administered everolimus therapy in May. A repeat CT in July revealed shrinkage of the mass, but a subsequent CT in November revealed slight enlargement of the tumor. Because the somatostatin receptor(SSTR-2)tested positive, concomitant octreotide acetate injection was initiated in December. Follow-up CT examinations revealed stabilization of the disease at first. However, the gradual enlargement of the tumor was noted thereafter. This case constitutes one of the few reports of the treatment of primary thymic carcinoid with everolimus and octreotide.