{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T04:57:30Z","timestamp":1758776250010,"version":"3.44.0"},"reference-count":103,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Enteric\u2010type thymic adenocarcinomas are an extremely rare and distinct subtype of thymic malignancies, as classified by the 2021 World Health Organization classification of thymic tumors. These tumors exhibit close molecular and morphologic similarity to primary gastrointestinal malignancies. To date, there are no tailored treatment guidelines for enteric\u2010type thymic adenocarcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>A 65\u2010year\u2010old woman was admitted to the Oncology unit of a Melbourne Metropolitan Hospital after presenting with progressive symptoms of thoracic outlet syndrome, where a CT scan identified a localized anterior mediastinal mass measuring up to 7.5\u2009\u00d7\u20096.0\u2009\u00d7\u20096.0\u2009cm (transverse\u2009\u00d7\u2009Anterior\u2013Posterior\u2009\u00d7\u2009Superior\u2013inferior). The mass was deemed unresectable. A core biopsy diagnosed the patient with a primary enteric\u2010type thymic adenocarcinoma, based on positive immunohistochemical staining for the intestinal markers CK20 and CDX2, positive staining for CD5\u2014a marker commonly associated with thymic carcinoma, and positive staining for CK7\u2014a marker not classically expressed in colonic adenocarcinoma. The patient received five fractions of 20 Gray palliative radiotherapy for superior vena cava syndrome, followed by four cycles of Oxaliplatin\/5\u2010fluorouracil\/leucovorin (FOLFOX) chemotherapy. FOLFOX, a common systemic therapy for gastrointestinal adenocarcinomas, was chosen due to the tumor's enteric profile and was selected over the then\u2010NCCN\u2010recommended carboplatin\/paclitaxel regimen, which did not have trial\u2010backed evidence of efficacy in thymic adenocarcinomas, particularly adenocarcinomas of the enteric type. After starting on frontline systemic therapy with FOLFOX, restaging scans after Cycle 3 showed a reduction in the size of her anterior mediastinal mass, which further decreased in size after cycle 4. Treatment was then discontinued per the patient's goals of care; however, follow\u2010up imaging showed ongoing disease stability for 6\u2009months. The patient died of disease 8\u2009months after treatment discontinuation and 13\u2009months after her initial diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We report the first case of primary enteric\u2010type thymic adenocarcinoma treated at an Australian institution, and the first published case using FOLFOX as frontline systemic therapy in a patient with unresectable primary enteric\u2010type thymic adenocarcinoma. Noting the close molecular resemblance between enteric\u2010type thymic adenocarcinoma and gastrointestinal malignancies, chemotherapy regimens commonly used in the treatment of gastrointestinal cancer may offer a more effective option than standard frontline therapies used in thymic carcinomas for the management of enteric\u2010type thymic adenocarcinoma.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.70318","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T11:20:22Z","timestamp":1756984822000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unresectable Primary Enteric\u2010Type Thymic Adenocarcinoma Treated With <scp>FOLFOX<\/scp> Chemotherapy: A Case Report"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7181-144X","authenticated-orcid":false,"given":"Carl","family":"He","sequence":"first","affiliation":[{"name":"Department of Oncology Eastern Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4601-4259","authenticated-orcid":false,"given":"Georgia","family":"Bentick","sequence":"additional","affiliation":[{"name":"Department of Oncology Eastern Health  Melbourne Australia"},{"name":"Peter MacCallum Cancer Centre  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9425-7841","authenticated-orcid":false,"given":"Patrick","family":"Hosking","sequence":"additional","affiliation":[{"name":"Department of Pathology Eastern Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1821-6374","authenticated-orcid":false,"given":"Andrew","family":"Mant","sequence":"additional","affiliation":[{"name":"Department of Oncology Eastern Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.808019"},{"issue":"4","key":"e_1_2_9_3_1","first-page":"717","article-title":"A Case of Adenocarcinoma of the Thymus","volume":"37","author":"Moriyama S.","year":"1989","journal-title":"Nihon Kyobu Geka Gakkai Zasshi"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-022-01779-6"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.10.010"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000359"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200301000-00014"},{"key":"e_1_2_9_8_1","unstructured":"NCCN Thymomas and Thymic Carcinomas: NCCN Clinical Practice Guidelines in Oncology(2025)."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2009.03.031"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyr089"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.32.9607"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu541"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtocrr.2024.100738"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(25)00001-4"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.592023"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-022-09441-3"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011954"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JTO.0000284677.33344.62"},{"key":"e_1_2_9_19_1","unstructured":"NCCN Non\u2010Small Cell Lung Cancer: NCCN Clinical Practice Guidelines in Oncology(2025)."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.5090\/kjtcs.2015.48.6.447"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmcr.2021.101497"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13691-022-00575-6"},{"key":"e_1_2_9_23_1","unstructured":"NCCN Colon Cancer: NCCN Clinical Practice Guidelines in Oncology 2025."},{"key":"e_1_2_9_24_1","unstructured":"NCCN Pancreatic Adenocarcinoma: NCCN Clinical Practice Guidelines in Oncology(2025)."},{"key":"e_1_2_9_25_1","unstructured":"NCCN Biliary Tract Cancers: NCCN Clinical Practice Guidelines in Oncology(2025)."},{"key":"e_1_2_9_26_1","unstructured":"NCCN Gastric Cancer: NCCN Clinical Practice Guidelines in Oncology(2025)."},{"key":"e_1_2_9_27_1","unstructured":"Ausmed Vital Signs Basics(2019)."},{"issue":"2","key":"e_1_2_9_28_1","first-page":"238","article-title":"Thymic Carcinoma\u2014A Rare Case Report","volume":"91","author":"Bansal N.","year":"2018","journal-title":"Clujul Medical Journal"},{"volume-title":"Treasure Island (FL): StatPearls Publishing Copyright 2024","year":"2024","author":"Almeida P. T.","key":"e_1_2_9_29_1"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2022.01.021"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.08.038"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2019.10.010"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1242\/dev.059998"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-1596-7-9"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyp150"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbc.2024.105675"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-97480-4"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3880175"},{"issue":"2","key":"e_1_2_9_39_1","first-page":"268","article-title":"CD5 Expression in Thymic Carcinoma","volume":"145","author":"Hishima T.","year":"1994","journal-title":"American Journal of Pathology"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41423-020-0490-z"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2015.02.010"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23806"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129039-200306000-00002"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.12742"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-45024-2_4"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/9957209"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/6405125"},{"issue":"6","key":"e_1_2_9_48_1","article-title":"Elevated Level of Serum Carcinoembryonic Antigen (CEA) and Search for a Malignancy: A Case Report","volume":"8","author":"Asad\u2010Ur\u2010Rahman F.","year":"2016","journal-title":"Cureus"},{"volume-title":"StatPearls. Treasure Island","year":"2024","author":"Kankanala V. L.","key":"e_1_2_9_49_1"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/bs.pmbts.2018.12.011"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181f209a8"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.5114\/kitp.2024.138581"},{"volume-title":"Treasure Island (FL): StatPearls Publishing Copyright 2024","year":"2024","author":"Gristan Y. D.","key":"e_1_2_9_53_1"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v15.i4.495"},{"key":"e_1_2_9_55_1","first-page":"124","article-title":"Enteric\u2010Type Adenocarcinoma of the Thymus: A Rare Diagnostic Challenge. A Case Report","volume":"23","author":"Mat\u00edas\u2010Cruz V.","year":"2023","journal-title":"Mexican Journal of Oncology"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-022-02000-8"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.29271\/jcpsp.2022.Supp2.S141"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v9.i7.1676"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/pin.13171"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2020.10.010"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2020.102133"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.13522"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.07.11"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-017-0781-1"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjw148"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.24920\/J1001-9294.2017.027"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-017-3282-9"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2016.11.012"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13691-015-0239-1"},{"issue":"5","key":"e_1_2_9_70_1","first-page":"5890","article-title":"Thymic Adenocarcinoma Associated With Thymic Cyst: A Case Report and Review of Literature","volume":"8","author":"Wang L.","year":"2015","journal-title":"International Journal of Clinical and Experimental Pathology"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.4132\/jptm.2015.04.16"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6890-13-17"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-012-0161-5"},{"key":"e_1_2_9_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.07.100"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.4132\/KoreanJPathol.2012.46.4.377"},{"key":"e_1_2_9_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2008.06.019"},{"key":"e_1_2_9_77_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181803eee"},{"key":"e_1_2_9_78_1","doi-asserted-by":"publisher","DOI":"10.1177\/1066896906290364"},{"key":"e_1_2_9_79_1","doi-asserted-by":"publisher","DOI":"10.5858\/2006-130-201-PMAOTT"},{"issue":"3","key":"e_1_2_9_80_1","article-title":"Thymic Adenocarcinoma With Metastasis to the Left Orbit: A Case Report","volume":"16","author":"Quevedo R.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_9_81_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqad150.127"},{"key":"e_1_2_9_82_1","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.13700"},{"key":"e_1_2_9_83_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP88FZTWANLRCB"},{"key":"e_1_2_9_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2018.01.011"},{"key":"e_1_2_9_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2018.09.030"},{"key":"e_1_2_9_86_1","doi-asserted-by":"publisher","DOI":"10.1111\/pin.12923"},{"key":"e_1_2_9_87_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.7623-21"},{"key":"e_1_2_9_88_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-024-03926-1"},{"issue":"4","key":"e_1_2_9_89_1","first-page":"831","article-title":"Capecitabine Plus Oxaliplatin Compared With 5\u2010Fluorouracil Plus Oxaliplatin in Metastatic Colorectal Cancer: Meta\u2010Analysis of Randomized Controlled Trials","volume":"3","author":"Zhang C.","year":"2012","journal-title":"Oncology Letters"},{"key":"e_1_2_9_90_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70151-7"},{"volume-title":"StatPearls. Treasure Island (FL)","year":"2025","author":"Amjad M. T.","key":"e_1_2_9_91_1"},{"key":"e_1_2_9_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2019.09.028"},{"key":"e_1_2_9_93_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2024.103706"},{"key":"e_1_2_9_94_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-12-3858"},{"key":"e_1_2_9_95_1","doi-asserted-by":"publisher","DOI":"10.1039\/C8DT00838H"},{"key":"e_1_2_9_96_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8027.2008.00156.x"},{"key":"e_1_2_9_97_1","doi-asserted-by":"publisher","DOI":"10.2174\/157015906776359568"},{"key":"e_1_2_9_98_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.24141"},{"key":"e_1_2_9_99_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2018.06.005"},{"key":"e_1_2_9_100_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2023.04.009"},{"key":"e_1_2_9_101_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30162-5"},{"key":"e_1_2_9_102_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2024.06.002"},{"key":"e_1_2_9_103_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30062-7"},{"key":"e_1_2_9_104_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00542-3"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.70318","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T04:06:43Z","timestamp":1758773203000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.70318"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":103,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/cnr2.70318"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.70318","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"type":"print","value":"2573-8348"},{"type":"electronic","value":"2573-8348"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70318"}}