title: Potential Role of Adjuvant Radiation Therapy in Cervical Thymic Neoplasm Involving Thyroid Gland or Neck.
abstract: OBJECTIVE
  The purpose of this study is to assess the clinicopathologic features, treatment outcomes, and role of adjuvant radiation therapy (RT) in cervical thymic neoplasm involving the thyroid gland or neck.
  
  
  METHODS
  The medical and pathologic records of eight patients with cervical thymic neoplasm were reviewed retrospectively. All patients underwent surgical resection, including thyroidectomy or mass excision. Adjuvant RT was added in five patients with adverse clinicopathologic features. The radiation doses ranged from 54 Gy/27 fractions to 66 Gy/30 fractions delivered to the primary tumor bed and pathologically involved regional lymphatics using a 3-dimensional conformal technique.
  
  
  RESULTS
  Eight cases of cervical thymic neoplasm included three patients with carcinoma showing thymus-like differentiation (CASTLE) and five with ectopic cervical thymoma. The histologic subtypes of ectopic cervical thymoma patients were World Health Organization (WHO) type B3 thymoma in one, WHO type B1 thymoma in two, WHO type AB thymoma in one, and metaplastic thymoma in one, respectively. The median age was 57 years (range, 40 to 76 years). Five patients received adjuvant RT: three with CASTLE; one with WHO type B3; and one with WHO type AB with local invasiveness. After a median follow-up period of 49 months (range, 11 to 203 months), no recurrence had been observed, regardless of adjuvant RT.
  
  
  CONCLUSIONS
  Adjuvant RT after surgical resection might be worthwhile in patients with CASTLE and ectopic cervical thymoma with WHO type B2-C and/or extraparenchymal extension, as similarly indicated for primary thymic epithelial tumors. A longer follow-up period may be needed in order to validate this strategy.
authors: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jae Myoung
authors: JM
authors: Noh
authors: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Sang Yun
authors: SY
authors: Ha
authors: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Yong Chan
authors: YC
authors: Ahn
authors: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Dongryul
authors: D
authors: Oh
authors: Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Seung Won
authors: SW
authors: Seol
authors: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Young Lyun
authors: YL
authors: Oh
authors: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Joungho
authors: J
authors: Han
keywords: Carcinoma; Neck; Radiotherapy; Thymus-like differentiation; Thyroid neoplasms
references: World J Surg. 2011 Aug;35(8):1840-6
references: 21597887
references: Int J Radiat Oncol Biol Phys. 2010 Dec 1;78(5):1400-6
references: 20378264
references: J Thorac Oncol. 2011 Jul;6(7):1282-6
references: 21642871
references: Head Neck. 2005 Oct;27(10 ):927-33
references: 15952197
references: Eur J Surg Oncol. 2007 Feb;33(1):83-5
references: 17085008
references: Hum Pathol. 1991 Apr;22(4):349-67
references: 2050369
references: Histopathology. 1998 Feb;32(2):104-9
references: 9543665
references: Pathol Res Pract. 2003;199(9):633-5
references: 14621201
references: Diagn Cytopathol. 2011 Mar;39(3):204-9
references: 20607745
references: J Thorac Cardiovasc Surg. 2007 Jun;133(6):1658-9
references: 17532980
references: Korean J Pathol. 2012 Jun;46(3):302-5
references: 23110020
references: J Cardiothorac Surg. 2011 Jul 06;6:89
references: 21733179
references: Acta Cytol. 1998 Sep-Oct;42(5):1167-71
references: 9755676
references: Korean J Pathol. 2012 Feb;46(1):92-5
references: 23109986
references: Acta Cytol. 2013;57(2):213-20
references: 23406665
references: Cancer. 1981 Dec 1;48(11):2485-92
references: 7296496
references: World J Surg. 1985 Feb;9(1):128-35
references: 3984364
references: Am J Surg Pathol. 2006 Aug;30(8):994-1001
references: 16861971
references: Br J Surg. 2004 Feb;91(2):142-5
references: 14760659
references: Am J Clin Pathol. 2007 Feb;127(2):230-6
references: 17210519
references: Cancer Res Treat. 2012 Sep;44(3):166-72
references: 23091442