As the conventional histopathologic examination of thymic carcinoma (TC) is nonspecific, immunohistochemical studies along with correlative radiographic investigations are needed for its correct diagnosis. TC commonly occurs in the late 5th to early 6th decades of life but is extremely rare in childhood. It may be incidentally detected from chest radiographs taken as routine or for other reasons. However, most patients present with symptoms such as chest pain, cough, shortness of breath, dysphagia and hoarseness, which are directly attributable to the mediastinal mass. Although TC frequently invades the neighboring organs, pleura and pericardium and metastasizes to the lymph nodes, liver and lung at the time of the first diagnosis, initial or late metastasis to the bone has been seldom reported in adults. Indeed, the English literature revealed no earlier report on initial bony metastasis in a child to date. We report a case of TC in a 12-year-old boy who initially presented with scapular osteolysis masquerading as a primary bone tumor to emphasize the usefulness of combined imaging for staging and histologic studies, particularly for such an unexpected case.

译文

由于胸腺癌 (TC) 的常规组织病理学检查是非特异性的,因此需要进行免疫组织化学研究以及相关的影像学检查才能正确诊断。TC通常发生在生命的第5至第6年初,但在儿童时期极为罕见。可能会从常规或其他原因的胸部x光片中偶然发现。然而,大多数患者出现胸痛,咳嗽,呼吸急促,吞咽困难和声音嘶哑等症状,这些症状直接归因于纵隔肿块。尽管TC在首次诊断时经常侵入邻近的器官,胸膜和心包,并转移到淋巴结,肝脏和肺,但在成年人中很少报道初次或晚期骨转移。事实上,英国文献显示,迄今为止,没有关于儿童最初骨转移的早期报道。我们报告了一个12岁男孩的TC病例,该男孩最初表现为肩胛骨骨溶解,伪装成原发性骨肿瘤,以强调联合成像对分期和组织学研究的有用性,尤其是对于这种意外情况。

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