title: About thymic carcinomas: challenges in diagnosis and management.
abstract: BACKGROUND
  Thymic carcinomas are rare tumors with a challenging diagnosis. Our aim was to report our 17-year experience of these tumors and to highlight the challenges encountered and the main differential diagnoses ruled out.
  
  
  METHODS
  We studied 12 (92%) men and 1 (7.7%) woman with a mean age of 37 years (range 15-60 years). All patients were symptomatic, with chest pain representing the most frequent symptom. Radiology revealed anterior mediastinal masses in all cases, with either infiltration of the adjacent organs or pulmonary parenchymal metastases.
  
  
  RESULTS
  The diagnosis was made on surgical biopsies in 12 cases and a lymph node biopsy in one. Microscopic examination revealed squamous carcinoma in 3 cases, synovial sarcoma in 1, mucinous adenocarcinoma in 1, undifferentiated carcinoma in 2, clear cell carcinoma in 1, lymphoepithelioma-like carcinoma in 2, atypical carcinoid tumor in 2, and sarcomatoid carcinoma in 1. Total surgical resection was possible in one patient after neoadjuvant chemotherapy and radiotherapy. Follow-up was possible in only 6 patients, and the mean survival reached 13 months.
  
  
  CONCLUSIONS
  In spite of the lack of follow-up information, this study demonstrates the poor outcome associated with these tumors and the need for standardized treatment.
authors.affiliation: Department of Pathology, Abderrahman Mami Hospital, Ariana, Tunisia mounamlika22@gmail.com.
authors.forename: Mouna
authors.initials: M
authors.lastname: Mlika
authors.affiliation: Department of Thoracic Surgery, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Sadok
authors.initials: S
authors.lastname: Boudaya
authors.affiliation: Department of Pathology, Abderrahman Mami Hospital, Ariana, Tunisia.
authors.forename: Emna
authors.initials: E
authors.lastname: Braham
authors.affiliation: Department of Pulmonology, Abderrahman Mami Hospital, Ariana, Tunisia.
authors.forename: Fatma
authors.initials: F
authors.lastname: Chermiti
authors.affiliation: Department of Pathology, Abderrahman Mami Hospital, Ariana, Tunisia.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sayi
authors.affiliation: Department of Thoracic Surgery, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
authors.forename: Adel
authors.initials: A
authors.lastname: Marghli
authors.affiliation: Department of Pathology, Abderrahman Mami Hospital, Ariana, Tunisia.
authors.forename: Faouzi
authors.initials: F
authors.lastname: El Mezni
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D059186:Chemoradiotherapy, Adjuvant; D002637:Chest Pain / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D013934:Thymectomy; D013945:Thymoma / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D013953:Thymus Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: Immunohistochemistry; Prognosis; Thymoma; Thymus neoplasms