[Thymic carcinoma effectively treated by preoperative concurrent chemo-radiotherapy]

A 59-year-old woman was admitted our hospital because of an abnormal shadow on a chest X-ray film. A chest CT scan showed a large anterior mediastinal tumor and a pericardial effusion. Percutaneous needle biopsy revealed that the tumor was an advanced thymic cancer (squamous cell carcinoma). The patient underwent 1 course of systemic chemotherapy (CDDP + VDS) with concurrent radiation therapy (24 Gy). In addition, one more course of chemotherapy (CDDP + VDS) was given. A chest CT scan done after therapy showed an approximately 75% reduction in tumor size (partial response) and disappearance of the pericardial effusion. The levels of tumor markers (SCC 8.3 ng/ml, CYFRA 21-1 183 ng/ml) also decreased to within the normal range. Finally, the thymic carcinoma and small pulmonary metastatic lesions were all resected. Examination of the resected tumor revealed extensive necrosis and only a few cancer cells. These results show that concurrent chemo-radiation therapy can be effective against inoperable squamous cell carcinoma of the thymus.