原発巣切除が病勢制御に有効と考えられたIV期胸腺原発粘液腺癌の1例
胸腺腺癌は，胸腺上皮性腫瘍のうち0.2%と非常に稀な腫瘍であり，その臨床病理学的特徴は十分解明されておらず，治療方針の明確なコンセンサスはない．今回我々は，原発巣切除後に病勢制御が得られたIV期胸腺原発粘液腺癌の1例を経験したので報告する．症例は46歳，男性．咳嗽と胸痛を主訴に撮像された胸部CT検査で前縦隔腫瘤を指摘され，前医での経皮的針生検にて胸腺腺癌と診断された．CTで左胸膜播種が疑われたが，症状緩和と腫瘍減量を目的に胸骨正中切開下で心膜，左腕頭静脈，左横隔神経合併切除を伴う胸腺全摘ならびに胸膜播種巣の可及的切除を施行した．病理組織学的診断は胸腺原発粘液腺癌，pT3N2M1a，TNM病理病...
Saved in:
| Published in | 日本呼吸器外科学会雑誌 Vol. 36; no. 2; pp. 156 - 162 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本呼吸器外科学会
15.03.2022
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 |
| DOI | 10.2995/jacsurg.36.156 |
Cover
| Abstract | 胸腺腺癌は，胸腺上皮性腫瘍のうち0.2%と非常に稀な腫瘍であり，その臨床病理学的特徴は十分解明されておらず，治療方針の明確なコンセンサスはない．今回我々は，原発巣切除後に病勢制御が得られたIV期胸腺原発粘液腺癌の1例を経験したので報告する．症例は46歳，男性．咳嗽と胸痛を主訴に撮像された胸部CT検査で前縦隔腫瘤を指摘され，前医での経皮的針生検にて胸腺腺癌と診断された．CTで左胸膜播種が疑われたが，症状緩和と腫瘍減量を目的に胸骨正中切開下で心膜，左腕頭静脈，左横隔神経合併切除を伴う胸腺全摘ならびに胸膜播種巣の可及的切除を施行した．病理組織学的診断は胸腺原発粘液腺癌，pT3N2M1a，TNM病理病期IVB期，正岡分類IVb期であった．術後再発が認められたが，化学療法を施行し，現在まで術後30ヵ月生存が得られている．完全切除不能な胸腺癌は予後不良とされるが，原発巣の外科切除が病勢制御に寄与する可能性が示唆された． |
|---|---|
| AbstractList | 胸腺腺癌は，胸腺上皮性腫瘍のうち0.2%と非常に稀な腫瘍であり，その臨床病理学的特徴は十分解明されておらず，治療方針の明確なコンセンサスはない．今回我々は，原発巣切除後に病勢制御が得られたIV期胸腺原発粘液腺癌の1例を経験したので報告する．症例は46歳，男性．咳嗽と胸痛を主訴に撮像された胸部CT検査で前縦隔腫瘤を指摘され，前医での経皮的針生検にて胸腺腺癌と診断された．CTで左胸膜播種が疑われたが，症状緩和と腫瘍減量を目的に胸骨正中切開下で心膜，左腕頭静脈，左横隔神経合併切除を伴う胸腺全摘ならびに胸膜播種巣の可及的切除を施行した．病理組織学的診断は胸腺原発粘液腺癌，pT3N2M1a，TNM病理病期IVB期，正岡分類IVb期であった．術後再発が認められたが，化学療法を施行し，現在まで術後30ヵ月生存が得られている．完全切除不能な胸腺癌は予後不良とされるが，原発巣の外科切除が病勢制御に寄与する可能性が示唆された． |
| Author | 菱田, 智之 淺村, 尚生 朝倉, 啓介 前田, 智早 江本, 桂 政井, 恭兵 |
| Author_xml | – sequence: 1 fullname: 菱田, 智之 organization: 慶應義塾大学医学部外科学（呼吸器） – sequence: 1 fullname: 政井, 恭兵 organization: 慶應義塾大学医学部外科学（呼吸器） – sequence: 1 fullname: 淺村, 尚生 organization: 慶應義塾大学医学部外科学（呼吸器） – sequence: 1 fullname: 朝倉, 啓介 organization: 慶應義塾大学医学部外科学（呼吸器） – sequence: 1 fullname: 江本, 桂 organization: 慶應義塾大学病院病理診断科 – sequence: 1 fullname: 前田, 智早 organization: 慶應義塾大学医学部外科学（呼吸器） |
| BookMark | eNo9kM1LAkEAxYcwyMxr_8Xa7Hw5exTpQxC6VLdYZqZZU8xi1w7dWkXSlK4lCNLHIQg6eLDy4D-zrWv_RRtKl_d4_B7v8NZBonZe0wBsmjCDLItuVYTyLt1SBrOMSdkKSJqcmwYxKU-AJLRMy4AWoWsg7XllCSFCCHPMkuA4vBtG_Un48Ry2b376L4Hfi-5bYfcpbI_D6WPgv80GnfD2K_Bf59fNwG8HjU7Q6AX-sHA0Gwznzc95a7LYiEYPs_EojlE_5u_m97S7AVYdUfV0eukpcLizfZDfM4r7u4V8rmhUEMkSgyjJiSNRlhMmCJaSCc6gUBILgTByKCEUEmkxTk6I4o6GVHEqLa2w1ipLcQrkFrsVry5K2r5wy2fCvbKFWy-rqraX79iY2ehP4ov-mToVblzAv-okguQ |
| ContentType | Journal Article |
| Copyright | 2022 特定非営利活動法人 日本呼吸器外科学会 |
| Copyright_xml | – notice: 2022 特定非営利活動法人 日本呼吸器外科学会 |
| DOI | 10.2995/jacsurg.36.156 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 1881-4158 |
| EndPage | 162 |
| ExternalDocumentID | article_jacsurg_36_2_36_156_article_char_ja |
| GroupedDBID | ABJNI ACGFS ALMA_UNASSIGNED_HOLDINGS JSF KQ8 OK1 RJT |
| ID | FETCH-LOGICAL-j2474-4cb84fb27846a43bb6a860acb3aa232f544504b9684d4c8fe05c85b9ec3eec753 |
| ISSN | 0919-0945 |
| IngestDate | Wed Sep 03 06:30:37 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 2 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2474-4cb84fb27846a43bb6a860acb3aa232f544504b9684d4c8fe05c85b9ec3eec753 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jacsurg/36/2/36_156/_article/-char/ja |
| PageCount | 7 |
| ParticipantIDs | jstage_primary_article_jacsurg_36_2_36_156_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2022/03/15 |
| PublicationDateYYYYMMDD | 2022-03-15 |
| PublicationDate_xml | – month: 03 year: 2022 text: 2022/03/15 day: 15 |
| PublicationDecade | 2020 |
| PublicationTitle | 日本呼吸器外科学会雑誌 |
| PublicationTitleAlternate | 日呼外会誌 |
| PublicationYear | 2022 |
| Publisher | 特定非営利活動法人 日本呼吸器外科学会 |
| Publisher_xml | – name: 特定非営利活動法人 日本呼吸器外科学会 |
| References | 1. Mukai K, Chan JKC, Detterbeck F, Marom EM, Marx A, Matsuno Y, et al. Adenocarcinomas. In: Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG, editors. WHO classification of Tumours of the Lung, Pleura, Thymus and Heart. Lyon: IARC Press; 2015: 226-8. 17. Takahashi F, Tsuta K, Matsuno Y, Takahashi K, Toba M, Sato K, et al. Adenocarcinoma of the thymus: mucious subtype. Hum Pathol 2005; 36: 219-23. 11. 坂根理司, 水野幸太郎, 小田梨紗, 松井琢哉, 伊藤 誠, 山田 健. 胸腺原発粘液腺癌の1例. 日呼外会誌 2014; 28: 904-9. 8. Tsuchida M, Umezu H, Hashimoto T, Shinohara H, Koike T, Hosaka Y, et al. Absence of gene mutations in KIT-positive thymic epithelial tumors. Lung Cancer 2008; 62: 321-5. 15. Choi WW, Lui YH, Lau WH, Crowley P, Khan A, Chan JK. Adenocarcinoma of the thymus: report of two cases, including a previously undescribed mucinous subtype. Am J Surg Pathol 2003; 27: 124-30. 3. Hishida T, Nomura S, Yano M, Asamura H, Yamashita M, Ohde Y, et al. Long-term outcome and prognostic factors of surgically treated thymic carcinoma: results of 306 cases from a Japanese Nationwide Database Study. Eur J Cardiothorac Surg 2016; 49: 835-41. 7. Dorfman DM, Shahsafaei A, Chan JK. Thymic carcinomas, but not thymomas and carcinomas of other sites, show CD5 immunoreactivity. Am J Surg Pathol 1997; 21: 936-40. 19. Liu HC, Hsu WH, Chen YJ, Chan YJ, Wu YC, Huang BS, et al. Primary thymic carcinoma. Ann Thorac Surg 2002; 73: 1076-81. 6. Ra SH, Fishbein MC, Baruch-Oren T, Shintaku P, Apple SK, Cameron RB, et al. Mucinous adenocarcinoma of the thymus: Report of 2 cases and review of the literature. Am J Surg Pathol 2007; 31: 1330-6. 4. 日本胸腺研究会編. 臨床・病理縦隔腫瘍取扱い規約. 第1版. 東京: 金原出版; 2009: 54-5. 10. Abdul-Ghafar J, Yong SJ, Kwon W, Park IH, Jung SH. Primary thymic mucinous adenocarcinoma: a case report. Korean J Pahol 2012; 46: 377-81. 9. Shepherd A, Riely G, Detterbeck F, Simone CB 2nd, Ahmad U, Huang J, et al. Thymic carcinoma management patterns among International Thymic Malignancy Interest Group (ITMIG) physicians with consensus from the Thymic Carcinoma Working Group. J Thorac Oncol 2017; 12: 745-51. 16. 関 幸雄, 今泉宗久, 重光希公夫, 吉岡 洋, 上田裕一. 前縦隔粘液産生腺癌の1例. 胸部外科 2004; 57: 413-6. 18. Kapur P, Rakheja D, Bastasch M, Molberg KH, Sarode VR. Primary mucinous adenocarcinoma of the thymus: a case report and review of the literature. Arch Pathol Lab Med 2006; 130: 201-4. 2. Huang J, Ahmad U, Antonicelli A, Catlin AC, Fang W, Gomez D, et al. Development of the International Thymic Malignancy Interest Group international database: An unprecedented resource for the study of a rare group of tumors. J Thorac Oncol 2014; 9: 1573-8. 5. Maghbool M, Ramzi M, Nagel I, Bejarano P, Siebert R, Saeedzadeh A, et al. Primary adenocarcinoma of the thymus: an immunohistochemical and molecular study with review of the literature. BMC Clin Pathol 2013; 13: 17. 12. Maeda D, Ota S, Ikeda S, Kawano R, Hata E, Nakajima J, et al. Mucinous adenocarcinoma of the thymus: a distinct variant of thymic carcinoma. Lung Cancer 2009; 64: 22-7. 13. Kinoshita F, Shoji F, Takada K, Toyokawa G, Okamoto T, Yano T, et al. Mucinous adenocarcinoma of the thymus: Report of a case. Gen Thorac Cardiovasc Surg 2018; 66: 111-5. 14. Akiba J, Harada H, Yokoyama S, Hashiguchi T, Kawahara A, Mitsuoka M, et al. Mucinous cystic tumor with CK20, nad CDX2 expression of the thymus: is this a benign counterpart of adenocarcinoma of the thymus, enteric type? Pathol Int 2016; 66: 29-33. |
| References_xml | – reference: 7. Dorfman DM, Shahsafaei A, Chan JK. Thymic carcinomas, but not thymomas and carcinomas of other sites, show CD5 immunoreactivity. Am J Surg Pathol 1997; 21: 936-40. – reference: 10. Abdul-Ghafar J, Yong SJ, Kwon W, Park IH, Jung SH. Primary thymic mucinous adenocarcinoma: a case report. Korean J Pahol 2012; 46: 377-81. – reference: 9. Shepherd A, Riely G, Detterbeck F, Simone CB 2nd, Ahmad U, Huang J, et al. Thymic carcinoma management patterns among International Thymic Malignancy Interest Group (ITMIG) physicians with consensus from the Thymic Carcinoma Working Group. J Thorac Oncol 2017; 12: 745-51. – reference: 17. Takahashi F, Tsuta K, Matsuno Y, Takahashi K, Toba M, Sato K, et al. Adenocarcinoma of the thymus: mucious subtype. Hum Pathol 2005; 36: 219-23. – reference: 19. Liu HC, Hsu WH, Chen YJ, Chan YJ, Wu YC, Huang BS, et al. Primary thymic carcinoma. Ann Thorac Surg 2002; 73: 1076-81. – reference: 11. 坂根理司, 水野幸太郎, 小田梨紗, 松井琢哉, 伊藤 誠, 山田 健. 胸腺原発粘液腺癌の1例. 日呼外会誌 2014; 28: 904-9. – reference: 16. 関 幸雄, 今泉宗久, 重光希公夫, 吉岡 洋, 上田裕一. 前縦隔粘液産生腺癌の1例. 胸部外科 2004; 57: 413-6. – reference: 14. Akiba J, Harada H, Yokoyama S, Hashiguchi T, Kawahara A, Mitsuoka M, et al. Mucinous cystic tumor with CK20, nad CDX2 expression of the thymus: is this a benign counterpart of adenocarcinoma of the thymus, enteric type? Pathol Int 2016; 66: 29-33. – reference: 3. Hishida T, Nomura S, Yano M, Asamura H, Yamashita M, Ohde Y, et al. Long-term outcome and prognostic factors of surgically treated thymic carcinoma: results of 306 cases from a Japanese Nationwide Database Study. Eur J Cardiothorac Surg 2016; 49: 835-41. – reference: 13. Kinoshita F, Shoji F, Takada K, Toyokawa G, Okamoto T, Yano T, et al. Mucinous adenocarcinoma of the thymus: Report of a case. Gen Thorac Cardiovasc Surg 2018; 66: 111-5. – reference: 5. Maghbool M, Ramzi M, Nagel I, Bejarano P, Siebert R, Saeedzadeh A, et al. Primary adenocarcinoma of the thymus: an immunohistochemical and molecular study with review of the literature. BMC Clin Pathol 2013; 13: 17. – reference: 8. Tsuchida M, Umezu H, Hashimoto T, Shinohara H, Koike T, Hosaka Y, et al. Absence of gene mutations in KIT-positive thymic epithelial tumors. Lung Cancer 2008; 62: 321-5. – reference: 6. Ra SH, Fishbein MC, Baruch-Oren T, Shintaku P, Apple SK, Cameron RB, et al. Mucinous adenocarcinoma of the thymus: Report of 2 cases and review of the literature. Am J Surg Pathol 2007; 31: 1330-6. – reference: 4. 日本胸腺研究会編. 臨床・病理縦隔腫瘍取扱い規約. 第1版. 東京: 金原出版; 2009: 54-5. – reference: 12. Maeda D, Ota S, Ikeda S, Kawano R, Hata E, Nakajima J, et al. Mucinous adenocarcinoma of the thymus: a distinct variant of thymic carcinoma. Lung Cancer 2009; 64: 22-7. – reference: 15. Choi WW, Lui YH, Lau WH, Crowley P, Khan A, Chan JK. Adenocarcinoma of the thymus: report of two cases, including a previously undescribed mucinous subtype. Am J Surg Pathol 2003; 27: 124-30. – reference: 18. Kapur P, Rakheja D, Bastasch M, Molberg KH, Sarode VR. Primary mucinous adenocarcinoma of the thymus: a case report and review of the literature. Arch Pathol Lab Med 2006; 130: 201-4. – reference: 1. Mukai K, Chan JKC, Detterbeck F, Marom EM, Marx A, Matsuno Y, et al. Adenocarcinomas. In: Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG, editors. WHO classification of Tumours of the Lung, Pleura, Thymus and Heart. Lyon: IARC Press; 2015: 226-8. – reference: 2. Huang J, Ahmad U, Antonicelli A, Catlin AC, Fang W, Gomez D, et al. Development of the International Thymic Malignancy Interest Group international database: An unprecedented resource for the study of a rare group of tumors. J Thorac Oncol 2014; 9: 1573-8. |
| SSID | ssib002223836 ssib002809429 ssib006158315 ssib000936850 ssib005901879 ssj0061428 ssib050939265 ssib003115996 ssib023160720 ssib002484544 ssib058493845 ssib006554584 |
| Score | 2.3017473 |
| Snippet | 胸腺腺癌は，胸腺上皮性腫瘍のうち0.2%と非常に稀な腫瘍であり，その臨床病理学的特徴は十分解明されておらず，治療方針の明確なコンセンサスはない．今回我々は，原発巣切... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 156 |
| SubjectTerms | 前縦隔腫瘍 胸腺 胸腺上皮性腫瘍 胸腺癌 胸腺腺癌 |
| Title | 原発巣切除が病勢制御に有効と考えられたIV期胸腺原発粘液腺癌の1例 |
| URI | https://www.jstage.jst.go.jp/article/jacsurg/36/2/36_156/_article/-char/ja |
| Volume | 36 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本呼吸器外科学会雑誌, 2022/03/15, Vol.36(2), pp.156-162 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Colorado Digital library customDbUrl: eissn: 1881-4158 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0061428 issn: 0919-0945 databaseCode: KQ8 dateStart: 19920101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV07b9RAELZCaGgQCBBvpWArdMfZ-_Au3e7FJwICCSlEadDJ9vmQUgQESUPFEUUkgGgoIBJSxKNAQqJIESAFf-a4XPgXzIx9d05EQYDG2tv9dmZ2Zu2d8e2OPe9CqjPZThNZUanPKyLUppIk8DCEUMGIVspbgs7CXL-hrtwSV2fl7Nj4y9KupcWFpJo-_O25kr-xKtSBXfGU7D4sOyQKFVAG-8IVLAzXP7IxiyTTETMNFoXMGOYs1riQWU5NmkGoHxlssoJFHNxGpusEDpmWhHHMBgXYKeoeMesXYOtYpJipM20IY5kzgybNIo37JDQfUNZUCAicF-pFk2lMzRSUUFiNnVxOQBZS7x1HyFzAjMZeIBeUR2DCDGnbCKQVKLZ2ZVeb-IEqZMHY1pGN8ZnLCzWSQJJyqAAqMgqp2xBhWDPJrCLiILclTTpq0sxakGAwW0m2BnM-yQbwGs5c4psPRqDetBvhFcEa1GKZkQM8jmeS1AFDlWU8WBUpQcdJFIHwEjkZW3A1jV3064hESjU0SIEHToYTVzeQp3jlEwS45y0_9Eo3KVKFjo4sb6OBAoB7RJRUMV_A7NaQhEQ1n1OGtO44FWiMzl787xYpv2fGU3ImzxlazfJVVmu_Ap6jLi_DeR6c4nETlNZUX6qSe-bni_felR-8KklfnEgfLN6_U-WqOuy2K5t6ca82C2CTq2aAF0A3B2143hEAB7yDQagUfhbl2s1SzGLwmw3lw-Pg9fJSjC60kGWfWcPoSzEIprcypRyXePhbl_4qhxBD85KPriT-tz2kB_GYqoWjGA8cfghxRlsVAGq4FsN3AApTKlLC0cIOeeZa1Nel3doCH3wOItLBblZysKePeIeLyHjC5uo56o3Nxce8270X6_21rd6X972VJz_XPnQ7z_uvlnvP3vVWNnvf33Y7n7bfrPaefut2Pu48Wup2VrqPV7uPn3c761Mz22_Wd5a-7ixv5TT6G6-3NzfgZ38N2j_7P74_O-7dakTT9SuV4oswlblAhKIi0kSLdoKbJVQseJKoWKtanCY8jiE0bGNmsZpIjNKiJVLdzmoy1TIxWcqzLA0lP-GNz9-dz056E1kb1iIeB0ncbgkTS20y8NhjsF5gVMtPTnmXc2007-Vpf5r7mDqn_6XzGe_Q6KY_640v3F_MzkHks5Ccp5n4C9cgD3A |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E5%8E%9F%E7%99%BA%E5%B7%A3%E5%88%87%E9%99%A4%E3%81%8C%E7%97%85%E5%8B%A2%E5%88%B6%E5%BE%A1%E3%81%AB%E6%9C%89%E5%8A%B9%E3%81%A8%E8%80%83%E3%81%88%E3%82%89%E3%82%8C%E3%81%9FIV%E6%9C%9F%E8%83%B8%E8%85%BA%E5%8E%9F%E7%99%BA%E7%B2%98%E6%B6%B2%E8%85%BA%E7%99%8C%E3%81%AE1%E4%BE%8B&rft.jtitle=%E6%97%A5%E6%9C%AC%E5%91%BC%E5%90%B8%E5%99%A8%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A%E9%9B%91%E8%AA%8C&rft.au=%E8%8F%B1%E7%94%B0%2C+%E6%99%BA%E4%B9%8B&rft.au=%E6%94%BF%E4%BA%95%2C+%E6%81%AD%E5%85%B5&rft.au=%E6%B7%BA%E6%9D%91%2C+%E5%B0%9A%E7%94%9F&rft.au=%E6%9C%9D%E5%80%89%2C+%E5%95%93%E4%BB%8B&rft.date=2022-03-15&rft.pub=%E7%89%B9%E5%AE%9A%E9%9D%9E%E5%96%B6%E5%88%A9%E6%B4%BB%E5%8B%95%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E5%91%BC%E5%90%B8%E5%99%A8%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A&rft.issn=0919-0945&rft.eissn=1881-4158&rft.volume=36&rft.issue=2&rft.spage=156&rft.epage=162&rft_id=info:doi/10.2995%2Fjacsurg.36.156&rft.externalDocID=article_jacsurg_36_2_36_156_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0919-0945&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0919-0945&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0919-0945&client=summon |