U THẦN KINH NỘI TIẾT NGUYÊN PHÁT TẠI TUYẾN ỨC: BÁO CÁO MỘT TRƯỜNG HỢP HIẾM GẶP VÀ HỒI CỨU Y VĂN

Abstract

Thymic neuroendocrine tumors (tNETs) are rare malignancies whose diagnosis is often challenging due to morphological overlaps with other mediastinal neoplasms, particularly thymoma. This report presents the case of a 48-year-old female patient presenting with chest pain and dyspnea, who was initially diagnosed with atypical type A thymoma based on a core needle biopsy. Imaging studies revealed a large anterior mediastinal mass with heterogeneous enhancement and central necrosis. However, the definitive diagnosis following complete surgical resection of the tumor was a grade 3 thymic neuroendocrine tumor. This was confirmed by a more comprehensive microscopic examination and supplementary immunohistochemical analysis, which demonstrated strong positivity for neuroendocrine markers (CD56, Synaptophysin, Chromogranin A) that were not included in the initial workup. This case highlights the potential pitfalls in diagnosing tNETs from small biopsy samples and underscores the importance of including neuroendocrine markers in the initial diagnostic panel for mediastinal tumors with atypical features. This practice is crucial for ensuring an accurate diagnosis, guiding appropriate therapeutic strategies, and improving patient prognosis.