[Advanced Enteric-type Thymic Adenocarcinoma with Axillary Lymph Node 
Oligometastasis: A Case Report].

Enteric‑type thymic adenocarcinoma (ETAC) is a rare subtype of thymic carcinoma. It shares highly similar histological and immunophenotypic features with intestinal adenocarcinoma, and is therefore prone to being misdiagnosed as metastatic carcinoma of gastrointestinal origin. Herein, we report a case of advanced ETAC with axillary lymph node oligometastasis. Positron emission tomography/computed tomography (PET/CT) and gastrointestinal endoscopy were performed to rule out primary gastrointestinal malignancy. The patient underwent median sternotomy with extended thymectomy, which effectively relieved superior vena cava obstruction and cardiopulmonary compressive symptoms. Postoperatively, systemic chemotherapy combined with immunotherapy, as well as regional radiotherapy targeting the primary tumor bed and metastatic lymph nodes, were administered. The patient remained disease‑free during the 24‑month postoperative follow‑up. This case suggests that aggressive local therapy combined with molecular‑subtype‑based systemic treatment may offer novel therapeutic opportunities for carefully selected patients with advanced ETAC and oligometastases.
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