Cerebral involvement of metastatic thymic carcinoma

The authors report the clinical presentations, radiological findings, and treatment outcome of thymic carcinoma patients with cerebral metastasis. The authors retrospectively reviewed the medical records of 49 patients with thymic carcinoma and 6 of them (12.2%) developed brain metastasis. There were 4 men and 2 women with a mean age of 48 years (ranging from 33 to 56 years). The pathological types of thymic carcinoma which developed brain metastasis were thymic carcinoma type C of the WHO classification in three patients, type B3 in one and carcinoid tumor in two patients. Surgical resection was performed as an initial treatment for brain lesions in three patients. Five patients received whole brain radiation therapy (WBRT) and radiosurgery was performed in one of them. The survival time was from 2 months in a patient with no treatment for brain lesions to 9 months in a patient who is still alive after surgical resection combined with WBRT and radiosurgery. There is high probability of metastasis particularly in thymic carcinoma type C or carcinoid tumor. Frequent surveillance and aggressive therapeutic approach are necessary to improve survival in these patients with cerebral involvement.