title: [A Recurrent Case of Thymic Adenocarcinoma Effectively Treated with S-1 Over a Long-Term Period].
abstract: A 61-year-old woman with an abnormal radiograph shadow in her anterior mediastinum was admitted to our hospital and underwent an extended thymectomy. The pathological diagnosis of the tumor was a non-papillary adenocarcinoma of the thymus in pathological stage IV b using the Masaoka classification owing to mediastinal lymph node metastasis. We found parasternal lymph node metastases 5 months after her first operation, and subsequently, she underwent surgery and adjuvant radiotherapy. We found systemic lymph node metastases and metastatic lesions in distant organs, including her lungs, brain, and kidney 27 months after her first operation. Systemic chemotherapy, such as carboplatin plus paclitaxel and an ADOC regimen were not very effective, so we performed immunohistochemical staining of the primary thymic adenocarcinoma. The levels of both thymidylate synthase and dihydropyrimidine dehydrogenase were low; therefore, we started S-1 100mg/body (2 weeks of administration, 1 week of withdrawal)31 months after her first operation. She entered complete remission 6 months after the initiation of S-1. We surgically resected her solitary lung metastasis 13 months after initiation of S-1, and then continued the S-1 treatment. There was no recurrence for more than 2 years after the lung surgery. We believe that when the expression levels of thymidylate synthase or dihydropyrimidine dehydrogenase are low in cases of recurrent thymic adenocarcinoma, S-1 may be able to induce an effective response.
authors.affiliation: Dept. of Thoracic, Cardiovascular and General Surgery, Kanazawa University.
authors.forename: Munehisa
authors.initials: M
authors.lastname: Takata
authors.forename: Isao
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Saito
authors.forename: Shuhei
authors.initials: S
authors.lastname: Yoshida
authors.forename: Seiichi
authors.initials: S
authors.lastname: Kakegawa
authors.forename: Masaya
authors.initials: M
authors.lastname: Tamura
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Takemura
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ikeda
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000556:secondary; D010094:Oxonic Acid / Q000627:therapeutic use*; D012008:Recurrence; D005641:Tegafur / Q000627:therapeutic use*; D013953:Thymus Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid