Translocation (11;15;19): a highly specific chromosome rearrangement associated with poorly differentiated thymic carcinoma in young patients.

Abstract

Thymic carcinoma is a rare epithelial neoplasm of the thymus. The presence of a specific chromosomal abnormality may augment diagnosis and therapeutic stratification. We report a 15-year-old boy diagnosed with thymic carcinoma who presented with a large anterior mediastinal mass, pleural effusion, and bone metastasis. The pleural fluid, cytology, bony lesions, and bone marrow were examined and chromosomal studies were performed. Histologic and immunohistochemical studies confirmed a poorly differentiated squamous cell type of thymic carcinoma. The karyotype of the pleural fluid at the time of diagnosis revealed a complex three-way translocation t(11;15;19)(p15;q12;p13.3). The constitutional karyotype was 46,XY. Five months after diagnosis, a bone marrow aspirate demonstrated tetraploidy with all translocation chromosomes in duplicate, as well as an unbalanced rearrangement involving chromosome 1: 92,XXYY,t(11;15;19)(p15;q12;p13.3)x2[15]/92,XXYY,idem,add(1)(qter)[5]. Despite aggressive multiagent chemotherapy, the patient's condition progressed with bone marrow disease and he died 6 months after diagnosis. Several case reports of a similar chromosomal abnormality have been reported for thymic carcinoma in young patients with poor outcome. This karyotypic abnormality appears to mark a cohort of patients with thymic carcinoma who have a poor prognosis despite aggressive chemotherapy.

• Authors: Jeffrey A Toretsky, James Jenson, Chen-Chih Sun, Allen E Eskenazi, Andrew Campbell, Stephen P Hunger, Aimee Caires, Christopher Frantz, J Laurance Hill, Judith Stamberg
• Journal: American journal of clinical oncology (Am J Clin Oncol) Vol. 26 Issue 3 Pg. 300-6 (Jun 2003) ISSN: 1537-453X [Electronic] United States
• PMID: 12796605 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S., Review)

Topics

• Adolescent
• Bone Neoplasms (genetics, pathology, secondary)
• Carcinoma, Squamous Cell (genetics, pathology, secondary)
• Chromosomes, Human, Pair 1
• Chromosomes, Human, Pair 11
• Chromosomes, Human, Pair 15
• Chromosomes, Human, Pair 19
• Cytogenetic Analysis
• Fatal Outcome
• Humans
• Immunohistochemistry
• Karyotyping
• Male
• Thymus Neoplasms (genetics, pathology)
• Translocation, Genetic