Long lasting efficacy of sorafenib in a heavily pretreated patient with thymic carcinoma.

Thymoma and thymic carcinoma are rare neoplasms of the mediastinum, arising from the epithelial cells of the thymus. While surgical resection is the treatment of choice in early stages, platin-based chemotherapy is mainly used in patients with advanced or metastatic disease; however, the prognosis is poor. Here we present the case of a 54 year old female patient suffering from a CD117-negative thymic carcinoma with widespread metastases. After several courses of different kinds of chemotherapy, finally these approaches failed to be effective. Thus we initiated a treatment with sorafenib, an inhibitor of several receptor tyrosine kinases. The treatment was tolerated very well, and within a few weeks the general condition of the patient improved significantly. A CT-scan, performed 3 months after therapy with sorafenib started, showed a 50 % reduction of tumor size, and this effect lasted for 15 months. When the carcinoma relapsed again, we administered another course of chemotherapy and, because of lacking success, we even tried to use sunitinib. However, the patient died in a septic shock, based on progressive disease. In summary, we present a patient with metastastic thymic carcinoma, in which sorafenib led to a tumor-control for 18 months.