Papillary adenocarcinoma in a thymic cyst: a pitfall of thoracoscopic excision

Carcinoma arising in a thymic cyst is very rare. We performed thoracoscopic subtotal resection of an assumed benign cyst. The patient had a reoperation when the diagnosis of papillary adenocarcinoma was established. Complete resection and pleural thermochemotherapy were performed. The patient died 26 months later from systemic metastases. Caution must be exercised when managing nontypical thymic cysts.     

Papillary adenocarcinoma arising in a thyroglossal cyst.

Carcinoma arising in a thyroglossal cyst is a rare but well-recognized condition. In this paper we present a further case of papillary adenocarcinoma arising in a thyroglossal cyst, and review the published experience of this condition.     

Thoracoscopic resection of a thoracic duct cyst that developed during follow-up for a thymic cyst

A 29-year-old man had been diagnosed with an anterior mediastinal cyst 6 years earlier and was undergoing follow-up. At a follow-up visit, a newly developed cystic lesion was found in the middle mediastinum; therefore, the anterior mediastinal cyst and the middle mediastinal cyst were resected by thoracoscopic surgery. It was observed that the middle mediastinal cyst originated from the thoracic duct, and the thoracic duct was clipped. Pathologically, the diagnosis was a thymic cyst of the anterior mediastinum and a thoracic duct cyst of the middle mediastinum. The patient developed chylothorax after surgery, and a second thoracoscopic operation was performed. It revealed that part of the clipping of the caudal thoracic duct was incomplete, and leakage of chyle was observed. Hence, the clipping was performed again. The course after the second surgery was good. Thoracic duct cysts are rare even among mediastinal cysts and thus require caution due to their tendency to expand.     

Papillary adenocarcinoma in a seminal vesicle cyst associated with contralateral renal agenesis: a case report

We report a case of papillary adenocarcinoma inside a seminal vesicle cyst associated with contralateral renal agenesis in a 30-year-old man. Coexistence of a seminal vesicle cyst and tumors is rare. Surgical excision was performed but he died due to liver metastases one year later.     

Malignant transformation in a thymic cyst

Thymic cysts have not been previously reported to show malignant transformation. This is the first documented case of well-differentiated papillary squamous cell carcinoma arising in a preexisting thymic cyst. The tumor was treated by surgical excision with no evidence of metastasis 6 1/2 years later.     

Papillary adenocarcinoma in a seminal vesicle cyst associated with ipsilateral renal agenesis: a case report.

Cysts and tumors of the seminal vesicle are uncommon, and their coexistence is extremely rare. We report a case of multiple papillary tumors inside a seminal vesicle cyst associated with ipsilateral renal agenesis in a 17-year-old man. Surgical excision of the cyst and tumors was performed without any morbidity and histology revealed well differentiated papillary adenocarcinoma.     

Papillary carcinoma in a thyroglossal duct cyst

Papillary carcinoma arising in a thyroglossal duct cyst is a rare tumor. We report the case of 64-year-old man treated for thyroglossal duct cyst. Preoperatively, the thyroid gland was normal on physical examination and imaging studies. The Sistrunk procedure was done. The histopathological examination revealed thyroid papillary carcinoma. Postoperatively thyroid hormon was given to suppress serum TSH levels and the patient was followed at regular intervals. During a 5-year follow-up period, no recurrence of the disease occured.     

Thymoma arising in a thymic cyst.

We present a case of thymoma arising in the wall of the thymic cyst. A 77-year-old asymptomatic woman demonstrated an approximately 3.5 cm sized cystic mass in the left anterior mediastinum in the CT scan. The tumor was extirpated by a total thymectomy. Histologically, the cyst wall was lined by low cuboidal cells, but a markedly thickened wall was observed at the upper site of the mass, which was found to be thymoma. These findings may suggest that the thymoma originated from the wall of the thymic cyst.     

Thymoma within a giant congenital thymic cyst

Congenital thymic cysts are very rare and mostly asymptomatic mediastinal lesions. Thymoma within such cysts is even more uncommon and has so far hardly been described. We report on a 41-year-old male with a World Health Organization type B1 thymoma within the wall of a huge unilocular thymic cyst. Because of the possible coexistence of typical congenital thymic cyst and thymoma, we recommend surgical resection both for establishing the diagnosis and for definite treatment.     

Papillary adenocarcinoma of ureter

A well-differentiated papillary adenocarcinoma developed in a ureteral stump thirty-six years after nephrectomy and was associated with a combined transitional-epidermoid carcinoma in the urinary bladder. Carcinoma in a ureteral stump is not uncommon and should be suspected in patients with a ureteral stump and hematuria. The very rare adenocarcinoma of the ureter is typically papillary and is associated with urinary tract infection and stones. At present successful treatment requires the early identification and extirpation of the ureteral tumor and consideration of associated cancer elsewhere in the urinary tract.     

Huge cervico-thoracic thymic cyst

We present a case of a 6 year-old boy who presented with a huge mass in the right side of the neck and changes its size with respiration and with straining. Computed tomography of the chest and neck showed a huge mass that was thought to be cystic hygroma. It was excised by both median sternotomy and a right cervical incision. Pathology revealed a thymic cyst.     

Papillary adenocarcinoma in thyroid hemiagenesis.

Variation in the gross anatomy of the thyroid gland is relatively common. Although thyroid hemiagenesis is felt to be a rare anomaly, its incidence is probably underestimated as the diagnosis is usually incidental. The case of a 41-year-old woman with right thyroid hemiagenesis associated with papillary adenocarcinoma is presented. The diagnosis of hemiagenesis was established by isotope imaging and surgical exploration for a benign nodule. Seven years later she was seen with a recurrent neck mass, and an isotope scan revealed it to be a cold thyroid nodule. As she was diagnosed to have papillary adenocarcinoma, total thyroid lobectomy was performed and at present she remains disease-free.