title: Spindle epithelial tumor with thymus-like differentiation: A case report and comprehensive review of the literature and treatment options.
abstract: BACKGROUND
  Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare cancer of thymic origin with little information available for treating clinicians.
  
  
  METHODS
  We performed a comprehensive literature search and updates were requested from all authors. We report one recent case.
  
  
  RESULTS
  We present the most comprehensive review of the clinical literature for SETTLE. We identified 41 published cases. SETTLE usually presents as an asymptomatic neck mass. Most patients successfully underwent surgical resection of the primary tumor. The mean latency to develop metastasis was 10 years. SETTLE is uniformly responsive to radiotherapy and combination chemotherapy in the rare cases where response data are available.
  
  
  CONCLUSIONS
  Although SETTLE is initially indolent, it has the capacity to metastasize late in its course. The malignant potential of this tumor might be underestimated because of the lack of long-term follow-up. In cases in which complete surgical resection is not possible, radiotherapy or combination chemotherapy is effective.
authors.affiliation: Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Buenos Aires, Argentina.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Recondo
authors.forename: Naifa
authors.initials: N
authors.lastname: Busaidy
authors.forename: Jeremy
authors.initials: J
authors.lastname: Erasmus
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Williams
authors.forename: Faye M
authors.initials: FM
authors.lastname: Johnson
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery; D002291:Carcinoma, Papillary; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology* / Q000628:therapy*; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000628:therapy; D035583:Rare Diseases; D018570:Risk Assessment; D013953:Thymus Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome
keywords: head and neck cancer; spindle epithelial tumor with thymus-like differentiation; therapy; thymic tumors