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¹Department of Pulmonology and Respiratory Medicine, Budhi Asih Hospital, Jakarta-Indonesia
²Department of Radiology, Universitas PRIMA, Medan-Indonesia
³Division of Thoracic Oncology, Department of Pulmonology and Respiratory Medicine, Universitas Indonesia Faculty of Medicine, Persahabatan Hospital, Jakarta-Indonesia DOI : 10.5505/tjo.2026.4783 Thymic carcinoma originated from epithelial cell thymus within the anterior mediastinum. Limited treatment options available for unresectable and metastatic disease. The emergence of immunotherapies for solid tumors has generated significant interest and PD-1 inhibitor have shown to be a promising alternative choice. We reported a case of a 47 year old male with presternal chest pain and dyspnoe underwent a chest CT in January 2024 in which showed anterior mediastinal mass 8.2×4.3×8.7 cm obliterating superior vena cava, supra azygos and brachiocephalic bilateral. In addition bilateral pleural and pericardial effusion were described. After core needle biopsy pathology result thymic carcinoma then a next generation sequencing study with no gene alteration was found. Patient received 20 times radiotherapy followed by chemotherapy based on ADOC regimen for 6 cycles accompanied with 3 cycles 200 mg Serplulimab three weekly. Final RECIST ver 1.1 reveal 13% tumor shrinking and disappearance of pleural effusion. The immune related adverse event only grade 1. Management of thymic epithelial neoplasm is a paradigm of multidisciplinary approach. Complete surgical resection is the only potentially curative option. For metastatic disease, palliative chemotherapy based on platinum is the first line standard therapy. A few prospective studies have investigated multiple novel agents such as immune check point inhibitors. To our knowledge this is the first case report use of serplulimab in extensive thymic carcinoma with encouraging results. However, given the high incidence of autoimmunity, irAEs should be carefully monitored. Keywords : PD1 inhibitor; serplulimab; thymic carcinoma