title: A case of carcinoma showing thymus-like differentiation with a rapidly lethal course.
abstract: A 55-year-old woman underwent a total thyroidectomy for carcinoma showing thymus-like differentiation (CASTLE). The patient was referred to our hospital after the tumor was found to have directly invaded the cervical esophagus and the entire circumference of the trachea. A total thyroidectomy was performed, followed by end-to-end anastomosis of the trachea, suprahyoid release and dissection of bilateral pulmonary ligaments. No major complications, including anastomotic dehiscence or stenosis, were observed. The patient experienced some swallowing disturbances and hoarseness during the perioperative period but fully recovered. Radiotherapy to the neck was performed as an adjuvant therapy. Eleven months after surgery, lower back pain and right leg numbness developed and led to gait inability. Multiple lung and bone recurrences were observed, but no local recurrence. Palliative radiotherapy to the bone metastasis was performed. The patient died of pleural metastasis 14 months after the initial diagnosis of CASTLE.
authors: Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors: Tomohiro
authors: T
authors: Nogami
authors: Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors: Naruto
authors: N
authors: Taira
authors: Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan.
authors: Shinichi
authors: S
authors: Toyooka
authors: Department of Pathology, Okayama University Hospital, Okayama, Japan.
authors: Takehiro
authors: T
authors: Tanaka
authors: Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors: Taeko
authors: T
authors: Mizoo
authors: Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors: Takayuki
authors: T
authors: Iwamoto
authors: Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors: Tadahiko
authors: T
authors: Shien
authors: Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan.
authors: Junichi
authors: J
authors: Soh
authors: Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan.
authors: Shinichiro
authors: S
authors: Miyoshi
authors: Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors: Hiroyoshi
authors: H
authors: Doihara
keywords: Carcinoma showing thymus-like differentiation; Infiltrating trachea; Reconstruction