A Case of Metastatic Thymoma Responsive to Treatment With 177Lu-DOTATATE

We describe a case of a 74-year-old woman with germline BRCA2 mutation, with an incidental diagnosis of metastatic thymoma presenting as a mediastinal mass with cardiac muscle and lymph node involvement. Despite surgical and radiotherapy treatment, there was marked advancement with new lung and liver metastases. All lesions demonstrated Ga-68-DOTATATE PET/CT uptake, and the patient received 4 peptide receptor radionuclide therapy cycles with Lu-177-DOTATATE, with pronounced reduction in the size of the liver, cardiac, and pleural lesions. This is the first case to demonstrate partial response to peptide receptor radionuclide therapy in metastatic thymoma, thus suggesting possible treatment option to refractory and advancing metastatic thymoma.

Automated summary

We present a case of a 74-year-old woman with germline BRCA2 mutation who was incidentally diagnosed with metastatic thymoma presenting as a mediastinal mass with cardiac muscle and lymph node involvement. Despite surgical and radiotherapy treatment, there was progression with new lung and liver metastases. Peptide receptor radionuclide therapy with Lu-177-DOTATATE resulted in significant reduction in the size of liver, cardiac, and pleural lesions, suggesting a potential treatment option for refractory and advancing metastatic thymoma.