• Le-Yao Li, Huan-Yu Zhao, Hai-Chao Tong, Ying-Chun Li, Hong-Tao Xu, Shuang Ma, Lian-He Yang, Wan-Lin Zhang, Tyler Wildes, and Endi Wang.
• Department of Pathology, the First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China.
• Medicine (Baltimore). 2023 Jun 2; 102 (22): e33847e33847.

RationaleAtypical thymic carcinoid tumor is an exceedingly rare thymic neuroendocrine tumor derived from the cells of neuroendocrine system. Misdiagnosis or delayed diagnosis may result in disease progression to advanced stages and eventually leads to a poor prognosis. It is therefore necessary to make a correct diagnosis and provide an adequate treatment.Patient ConcernsA 33-year-old Chinese male presented with numbness in bilateral lower extremities and general fatigue for a month. Chest computed tomography revealed a superior anterior mediastinal mass. Thymoma was initially considered, given the location of the mass and radiographic presentation.DiagnosisMicroscopic findings showed that the tumor cells are arranged in pseudoepitheliomatous growth or irregular nested growth pattern in a background of fibroconnective tissue, with focal infiltration into adipose tissue. The chrysanthemum-like structure or beam-like structure seen often in typical carcinoid tumor was not identified in this case. The tumor cells are spindled or oval, with focal active mitosis. The immunohistochemical staining showed strong positivity for CD56, CgA and Syn, positivity for CK, ACTH, and TTF-1, negativity for Vimentin, and ki67 labeled proliferation index was up to 10% in focal areas. According to the radiological and pathological findings, the diagnosis of atypical thymic carcinoid was made.InterventionsThe patient underwent surgical resection of the mass.OutcomeNo recurrence or metastasis was identified during the follow up.LessonsBecause of its low incidencen, onspecific clinical symptoms, tissue location, and radiological findings, atypical thymic carcinoid tumor may sometimes be misdiagnosed as thymoma. Attention should be paid to avoid misdiagnosis.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

29 keywords...

hide…