Stage IB malignant thymoma in a Lynch syndrome patient with multiple cancers: response to incidental administration of oxaliplatin and 5-fluorouracil.

ABSTRACT

Chemotherapy is active against malignant thymomas, improving the resectability rate and the outcome of the advanced stages. The CAP and ADOC schemes are considered the standard schedules today, but these regimens can have important side effects in patients treated with combined approaches, such as toxic deaths due to congestive heart failure or hepatic insufficiency. We report the case of a 55 year-old woman with a history of multiple neoplasms including a mixed malignant thymoma WHO type B2 and three synchronous adenocarcinomas of the colon. The patient refused to undergo surgical resection of her mediastinal mass. However, 8 cycles of chronomodulated oxaliplatin, 5-fluorouracil and leucovorin as adjuvant treatment for her colon cancers resulted in a > 30% decrease in the longest diameter of the mediastinal mass. This occasional observation may be important for clinicians and especially for those faced with relapsed, cisplatin-refractory disease or when planning new studies aiming to reduce overall toxicity of multimodal schedules.