• T Araki, L M Sholl, H Hatabu, and M Nishino.
• Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA. Electronic address: taraki@partners.org.
• Clin Radiol. 2018 May 1; 73 (5): 479-484.

AimTo investigate the clinical and image features of thymic neuroendocrine tumours (NETs), and characterise the radiological patterns of recurrence and metastasis on serial imaging studies.Materials And MethodsThe study included 14 patients (11 males) with a histopathological diagnosis of thymic NETs (one typical carcinoid, eight atypical carcinoid, and five large cell neuroendocrine carcinoma). Preoperative images were assessed for features of primary tumours. Follow-up imaging studies were evaluated for the patterns of metastasis or recurrence.ResultsUnderlying endocrine or autoimmune disorders were present in four patients (29%), including multiple endocrine neoplasia (MEN) type 1 (n=3) and autoimmune thyroiditis (n=1). On preoperative imaging, the primary tumours were commonly lobulate and heterogeneous, infiltrated the surrounding fat, and showed ≥50% abutment of the mediastinal structures, with the mean longest diameter of 14 cm (range: 4.1-28 cm). No significant differences of preoperative imaging features were noted among histopathological subtypes. Metastasis or recurrence was noted in 11 of the 14 patients (79%). Ten patients developed intrathoracic metastasis or recurrence, involving thoracic lymph nodes (n=7), pleura (n=4), lung (n=4), pericardium (n=4), and local recurrence in the postoperative mediastinum (n=3). Eight of the 11 patients also had extra-thoracic metastasis, involving bone (n=6), abdominal lymph nodes (n=4), liver, pancreas, kidney, adrenal gland, spleen and brain (n=1 for each site).ConclusionsThymic NETs presented as a large, lobulate, heterogeneous mass with an infiltrative nature. Metastasis and recurrence were frequent, most commonly involving thoracic lymph nodes, while extra-thoracic metastasis to bones and abdominal lymph nodes were also noted.Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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