Co-existing Thymolipoma and Primary Lung Cancer: Case Report

Yıl 2008, Cilt: 2 Sayı: 3, 395 - 398, 20.11.2008

Adnan Yilmaz

Öz

A case with coexisting thymolipoma and primary lung cancer was presented. A 42 year- old-man was referred to a physician on December 2003 complaining of fatigue and eyelid weakness for 2 years. Pyridostigmine (mestinon) and azathioprine treatment was started with the diagnosis of Lambert-Eaton syndrome. Computed tomography of the thorax was reported as normal. Five months later, on May 2004 it showed a solitary pulmonary nodule on left upper lobe which is 1cm in diameter. Bronchoscopic appearance was normal. A mass lesion three centimeter in diameter in anterior mediastinum and a nodule 1x1 cm in diameter in left upper lobe were seen at thoracotomy. Mediastinal mass was removed and left upper lobectomy was performed. Mediastinal mass was a thymolipoma and the nodule on left upper lobe was reported as an adenocarcinoma. The pathological stage of lung cancer was TINI Mx. There was no evidence of recurrence or residual tumor 3 years after surgery.

Anahtar Kelimeler

Thymolipoma, primary lung cancer, coexistence, Lambert-Eaton Syndrome, myasthenia gravis

Timolipoma ve Primer Akciğer Kanseri Birlikteliği

Öz

Timolipoma ve akciğer kanseri birlikteliğinin bir olgusu sunuldu. Kırk iki yaşında erkek hasta 2 yıldır devam eden halsizlik ve göz kapağında güçsüzlük yakınmaları ile Aralık 2003’de doktora başvurmuş. Hastaya Lambert-Eaton Sendromu tanısı ile piridostigmin (mestinon) ve azothiopirin başlanmıştı. Toraks bilgisayarlı tomografisi normal olarak rapor edilmişti. Beş ay sonra, Mayıs 2004’de tomografi sol üst lobda 1 cm çapında bir soliter pulmoner nodül gösteriyordu. Hasta merkezimize sevk edilmişti. Bronkoskopik görünüm normaldi. Torakotomide, ön mediastende 3 cm çaplı kitle ve sol üst lobda 1x1 cm boyutunda nodül görüldü. Mediastinal kitle çıkartıldı ve sol üst lobektomi yapıldı. Mediastinal kitle timolipoma idi ve sol üst lobdaki nodül adenokarsinom olarak rapor edildi. Akciğer kanserinin patolojik evresi T1N1Mx idi. Cerrahiden 3 yıl sonra nüks veya rezidüel tümör bulgusu yoktu.

Adnan YILMAZ, ,
Ebru DAMADOĞLU,
Leyla YAĞCI TUNCER,
Ebru SULU,
Huriye BERK TAKIR,
Volkan BAYSUNGUR,
Reha BARAN,

Anahtar Kelimeler

Timolipoma, primer akciğer kanseri, birliktelik, Lambert-Eaton sendromu, miyastenia gravis

Kaynakça

• 1. Gamondes JP, Balawi A, Greenland T. Seventeen years of surgical treatment of thymoma: factors influencing survival. Eur J Cardiothorac Surg 1991; 5:124-31.
• 2. Otto HF, Loning T, Lachenmayer L et al. Thy-molipoma in association with myasthenia gravis. Cancer 1982; 50:1623-8.
• 3. Takamouri S, Hayashi A, Tayama S et al. Thy-molipoma associated with myasthenia gravis. Scand Cardiovasc J 1997; 31: 241-2.
• 4. Pillai R, Yeoh N, Addis B et al. Thymolipoma in associated with Hodgkin’s disease. J Tho-rac Cardiovasc Surg 1985; 90:306-8.
• 5. Ogino S, Frank TJ, Deubner H, Koss MN. Thy-mohemangiolipoma, a rare histologic variant of thymolipoma: A case report and review of the literature. Ann Diagn Pathol 2000; 4:236-9.
• 6. Pan CC, Chen PCH, Wang LS, Chi KH, Chiang H. Thymoma is associated with an in- creased risk of second malignancy. Cancer 2001; 92: 2406-11.
• 7. Welsh JS, Wilkins KB, Green R et al. Association between thymoma and second neoplasms. JAMA 2000; 283:1142-3.
• 8. Shimada T, Terashima H, Shimizu T, Hirayama K. Invasive thymoma associated with lung cancer: Report of a case. Surg Today 2001;31:507-9.
• 9. Iwata T, Inoue K, Mizuguchi S, Morita R, Tsukioka T, Suehiro S. Thymic small cell carcinoma associated with pulmonary squamous cell carcinoma. Ann Thorac Surg 2006; 82: 2266-8.
• 10. Welsh JS, Thurman SA, Howard SP.Thy-moma and multiple malignancies: A case of five synchronous neoplasms and literature review. Clin Med Research 2003; 1:227-32.
• 11. Maekawa S, Okabayashi K, Hiratsuka M et al. Thymolipoma with high production of carbo- hydrate antigen 19-9. J Thorac Cardiovasc Surg 2004; 127:1845-7.
• 12. Rosado-de-Christerson ML, Pugatch RD, Moran CA, Galobardes J. Thymolipoma: Analysis of 27 cases. Radiology 1994; 193: 121-6.
• 13. Damadoglu E, Salturk C, Takir HB et al. Mediastinal thymolipoma: analysis of 10 cases. Respirology 2007; 12: 924-7.
• 14. Pan CH, Chiang CY, Chen SS. Thymolipoma in patients with myasthenia gravis: report of two cases and review. Acta Neurol Scand 1988; 78:16-21.
• 15. Kilic D, Semih G, Aka BF et al. A rare combination of thymic tumor: Radiologically invisible thymolipoma associated with myasthenia gravis. Neurol India 2006; 54: 322-4.
• 16. Chew FS, Weissleder R. Mediastinal thymolipoma. AJR 1991; 157: 468.