• Yi-Wen Zheng, Lin-Lin Bai, Gui-Yang Jiang, Xu-Yong Lin, Yang Liu, and Hong-Tao Xu.
• Department of Pathology, the First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang.
• Medicine (Baltimore). 2021 Apr 16; 100 (15): e25254e25254.

RationaleThymic adenocarcinoma is an extremely rare thymic carcinoma. The exact genetic alteration associated with thymic adenocarcinoma is unclear. Here, we report a case of thymic adenocarcinoma accompanied by type A thymoma and pulmonary minimally invasive adenocarcinoma (MIA).Patient ConcernsA 53-year-old woman presented with multiple nodules in the mediastinum and lung. Thoracic computed tomography revealed nodules in the anterior superior mediastinum and anterior mediastinum near the right pericardium and ground-glass opacity (GGO) in the right superior lobe of the lung.DiagnosisThe tumor in the anterior superior mediastinum was diagnosed as primary thymic papillary adenocarcinoma. The tumor in the anterior mediastinum near the right pericardium was diagnosed as type A thymoma. The GGO of the right superior lobe of the lung was diagnosed as a MIA.InterventionThe patient underwent thoracoscopic mediastinal tumor resection and partial lobectomy in our hospital.OutcomesThe postoperative course was uneventful. The patient is alive and free of the disease for 22 months after diagnosis.LessonsThyroid transcription factor 1 (TTF-1) was positive in this case of thymic adenocarcinoma, which indicated that a thymic adenocarcinoma with TTF-1-positive may not necessarily be a metastasis of lung or thyroid adenocarcinoma. The positive staining of CD5 and CD117 can help us to confirm the thymic origin. Molecular genetic analysis indicated that these tumors harbored different mutations. The thymic adenocarcinoma and type A thymoma both had the mutation of KMT2A, but the mutation sites were different. KMT2A mutation may be a common genetic change in thymic tumorigenesis. The genetic alterations disclosed in this study will help expand the understanding of thymic tumors.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

29 keywords...

hide…