A Case of Thymic Carcinoma with Histologically Proven Brain Metastasis Alive

We report the case of a 40-year-old man who noticed swelling from the left side of the neck to the upper extremities from September 1996. He did not consulting a doctor for several months. He was admitted to our hospital in March 1997 because of left blepharoptosis and pain in the left neck. Chest CT and MRI revealed a tumor mass in the left upper mediastinum involving the left common carotid artery and the subclavian artery. Furthermore, head CT and MRI showed a tumor mass in the lobus occipitalis. We performed an open chest biopsy and obtained a histological diagnosis of carcinoma planocellular, a primary thymic carcinoma. A second biopsy and a drainage under CT guide for the head tumor showed that it was a brain metastasis from the thymic carcinoma. We performed radiation therapy on the left upper mediastinum and the metastatic lesion in the brain, followed by three courses of systemic chemotherapy. Unfortunately, however, the treatment had no effect on the primary lesion and the brain metastasis. As it is rare to histologically prove brain metastasis of a thymic carcinoma before a patient's death, we report this case to supplement the literature.