A case of advanced thymic cancer successfully treated with neoadjuvant intra-arterial infusion chemotherapy

We report the case of a 68-year-old man with advanced thymic cancer who was diagnosed as having squamous cell carcinoma by percutaneous needle biopsy. The CT scan showed pre-cardiac and pulmonary invasion, therefore the tumor was classified as Masaoka's stage III. Induction systemic chemotherapy consisting of CDDP (70 mg/m2, day 1), ADM (40 mg/m2, day 1) and ETP (70 mg/m2, day 1-3) was performed for the purpose of reducing the tumor size; however, the tumor's size did not shrink. Therefore, second line chemotherapy combined with selective intra-arterial infusion chemotherapy and systemic chemotherapy consisting of CDDP (70 mg/m2, day 1; intra-arterial), ADM (30 mg/m2, day 1; intra-arterial), VCR (0.5 mg/m2, day 3; systemic) and CPA (500 mg/m2, day 3; systemic) was performed. After this treatment, the tumor was reduced in size, and an extended thymectomy was subsequently performed. The histological diagnosis of the resected tumor was squamous cell carcinoma. Examination of the resected tumor revealed extensive necrosis and only a few cancer cells. These results show that intra-arterial infusion chemotherapy may be effective for local control of advanced thymic cancer.