title: Chemosensitivity in Carcinoma Showing Thymus-Like Differentiation: A Case Report and Review of the Literature.
abstract: BACKGROUND
  Carcinoma showing thymus-like differentiation (CASTLE) is an extremely rare malignant neoplasm of the thyroid that originates from ectopic thymic tissue. No sufficient evidence exists regarding the efficacy of chemotherapy for cases with distant metastases or advanced disease because of the rarity of the disease itself.
  
  
  METHODS
  We report a case of CASTLE with lung metastasis that showed good responses to first-line (cisplatin, doxorubicin, vincristine, and cyclophosphamide) and second-line (carboplatin and paclitaxel) chemotherapies.
  
  
  CONCLUSIONS
  This is the first case of CASTLE reported to show a good response to two serial chemotherapies.
  
  
  CONCLUSIONS
  This case suggests that CASTLE is a chemosensitive tumor and that chemotherapy should be attempted in patients with advanced or metastatic CASTLE.
authors.affiliation: 1 Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto, Nagano, Japan .
authors.forename: Toru
authors.initials: T
authors.lastname: Hanamura
authors.affiliation: 1 Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto, Nagano, Japan .
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Ito
authors.affiliation: 2 Department of Laboratory Medicine, Shinshu University School of Medicine , Matsumoto, Nagano, Japan .
authors.forename: Takeshi
authors.initials: T
authors.lastname: Uehara
authors.affiliation: 3 Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine , Matsumoto, Nagano, Japan .
authors.forename: Toshirou
authors.initials: T
authors.lastname: Fukushima
authors.affiliation: 3 Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine , Matsumoto, Nagano, Japan .
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: 3 Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine , Matsumoto, Nagano, Japan .
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Koizumi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002277:Carcinoma / Q000188:drug therapy* / Q000556:secondary; D002454:Cell Differentiation; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D049268:Positron-Emission Tomography; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin