Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2015; 3(11): 946-950
Published online Nov 16, 2015. doi: 10.12998/wjcc.v3.i11.946
First description of cervical intradural thymoma metastasis
Nicola Marotta, Cristina Mancarella, Davide Colistra, Alessandro Landi, Demo Eugenio Dugoni, Roberto Delfini
Nicola Marotta, Cristina Mancarella, Davide Colistra, Alessandro Landi, Demo Eugenio Dugoni, Roberto Delfini, Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza”, 00161 Rome, Italy
Author contributions: All the authors contributed to this manuscript.
Institutional review board statement: The study was reviewed and approved by the Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza” Institutional review board.
Informed consent statement: The study participant provided informed verbal consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alessandro Landi, MD, PhD, Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy. dott.alessandro.landi@gmail.com
Telephone: +39-6-49979105 Fax: +39-6-49979105
Received: February 11, 2015
Peer-review started: February 12, 2015
First decision: May 13, 2015
Revised: May 30, 2015
Accepted: August 30, 2015
Article in press: August 31, 2015
Published online: November 16, 2015
Abstract

Thymoma and thymic carcinoma are rare epithelial tumors, which originate from the thymus gland. According to the World Health Organization there are “organotypic” (types A, AB, B1, B2, and B3) and “non-organotypic” (thymic carcinomas) thymomas. Type B3 thymomas are aggressive tumors, which can metastasize. Due to the rarity of these lesions, only 7 cases of extradural metastasis are described in the literature. We report the first and unique case of a man with cervical intradural B3 thymoma metastasis. A 46-year-old man underwent thymoma surgical removal. The year after the procedure he was treated for a parietal pleura metastasis. In 2006 he underwent cervical-dorsal extradural metastasis removal and C5-Th1 stabilization. Seven years after he came to our observation complaining left cervicobrachialgia and a reduction of strength of the left arm. He underwent a cervical spine magnetic resonance imaging, which showed a new lesion at the C5-C7 level. The patient underwent a surgery for the intradural B3 thymoma metastasis. Neurological symptoms improved although the removal was subtotal. He went through postoperative radiation therapy with further mass reduction. Spinal metastases are extremely rare. To date, only 7 cases of spinal extradural metastasis have been described in the literature. This is the first case of spinal intradural metastasis. Early individuation of these tumors and surgical treatment improve neurological outcome in patients with spinal cord compression. A multimodal treatment including neoadjuvant chemotherapy, surgery and postoperative radiation therapy seems to improve survival in patients with metastatic thymoma.

Keywords: Thymoma, Metastasis, Intradural lesion, Spinal tumor, Spinal surgery

Core tip: To date, only 7 cases of spinal extradural thymoma metastasis have been described in the literature. We report the first case of spinal intradural thymoma metastasis. Early individuation of these tumors and surgical treatment improve neurological outcome in patients with spinal cord compression. A multimodal treatment including neoadjuvant chemotherapy, surgery and postoperative radiation therapy seems to improve survival in patients with metastatic thymoma.