Atypical thymic carcinoid associated with rapidly progressive symptoms of Cushing's syndrome in a child

Atypical thymic carcinoid in children is rare and its prognosis principally depends on the completeness of the surgical resection. We report a case of atypical thymic carcinoid with lymph node metastasis that had not been identified prior to surgery. An 8-year-old boy was referred because of Cushing...

Full description

Saved in:
Bibliographic Details
Published inJournal of pediatric surgery case reports Vol. 86; p. 102474
Main Authors Abe, Takatoshi, Sakai, Seisho, Nomura, Kozo, Mizushima, Honami, Hayashi, Kentaro, Sakai, Yuta, Noguchi, Kazuhiro, Fujiki, Toshihiro, Kuroda, Rie, Ikawa, Yasuhiro, Saito, Daisuke, Matsumoto, Isao
Format Journal Article
LanguageEnglish
Published Elsevier Inc 01.11.2022
Elsevier
Subjects
Atypical thymic carcinoid
FDG-PET
Lymph node metastasis
Surgery
Lymph node metastasis
FDG-PET
CT
ACTH
FDG
Atypical thymic carcinoid
PET
computed tomography
fluorodeoxyglucose
positron emission tomography
adrenocorticotropic hormone
Online AccessGet full text

Cover

More Information
Summary:Atypical thymic carcinoid in children is rare and its prognosis principally depends on the completeness of the surgical resection. We report a case of atypical thymic carcinoid with lymph node metastasis that had not been identified prior to surgery. An 8-year-old boy was referred because of Cushing's syndrome and a worsening of his symptom, which included facial edema, fatigue, and headache, over 3 weeks. Blood testing revealed high plasma cortisol and adrenocorticotropic hormone (ACTH), and chest computed tomography demonstrated two tumors in his anterior mediastinum, but no findings suggestive of lymph node metastasis. We suspected the presence of an ACTH-producing thymic carcinoid tumor; therefore, the patient underwent total thymectomy and dissection of his anterior mediastinal and bilateral deep cervical lymph nodes. Histopathological examination revealed an atypical carcinoid tumor and left cervical lymph node metastasis. The patients' plasma cortisol and ACTH concentrations decreased after surgery, and he was further treated with radiotherapy and combination chemotherapy. Thus, it is possible that the development of symptoms may indicate more rapid progression of atypical thymic carcinoid, and deep cervical lymphadenectomy is necessary for its complete resection.
ISSN:2213-5766
2213-5766
DOI:10.1016/j.epsc.2022.102474