-
Medicina (Kaunas, Lithuania) Apr 2022Thymoma is an epithelial mass arising from the thymus. Most thymomas are located in the anterior mediastinum. Ectopic intrapericardial thymoma is very unusual; to date,...
BACKGROUND
Thymoma is an epithelial mass arising from the thymus. Most thymomas are located in the anterior mediastinum. Ectopic intrapericardial thymoma is very unusual; to date, only eight cases of pericardial thymoma have been reported. Among thymoma patients, 20% to 25% are associated with myasthenia gravis. However, postoperative myasthenia gravis occurs in less than 1% of cases. Here, we share a rare case of ectopic intrapericardial thymoma that developed postoperative myasthenia gravis six months after surgery.
CASE PRESENTATION
A 66-year-old woman visited the outpatient department due to productive cough and chest pain. Chest radiography showed increased soft tissue opacity over the mediastinum. A soft tissue mass in the pericardium and a ground glass nodule in right upper lung were noted using chest computed tomography. The diagnosis of thymoma, type B2, pT3N0M0, and stage IIIA and synchronous adenocarcinoma in situ of the right upper lung was confirmed after surgical removal. Six months later, the patient developed postoperative myasthenia gravis.
CONCLUSIONS
Thymoma is rarely considered a differential diagnosis in pericardial tumors. Surgical removal with adjuvant radiation therapy should be performed considering the malignancy potential of thymomas and cardiac complications. In patients without myasthenia gravis, a small chance of postoperative myasthenia gravis remains. Patients should be carefully monitored for myasthenia gravis after surgery.
Topics: Aged; Cardiac Tamponade; Female; Humans; Myasthenia Gravis; Pericardium; Thymoma; Thymus Neoplasms
PubMed: 35630026
DOI: 10.3390/medicina58050609 -
The Annals of Thoracic Surgery Aug 2008The literature describing multimodal treatment of thymomas consists almost exclusively of retrospective case series. We have used a systematic review to investigate the... (Review)
Review
The literature describing multimodal treatment of thymomas consists almost exclusively of retrospective case series. We have used a systematic review to investigate the role of surgery in the management of thymomas. The use of surgery as the sole therapeutic maneuver in thymoma depends on the stage considered. Subtotal resection followed by adjuvant treatment may prolong survival, but studies are equivocal. Some data supports re-resection of recurrent thymoma in the belief that survival will be prolonged. Approaches to thymectomy other than sternotomy in early stage thymoma are technically sound, but long-term outcome data are lacking.
Topics: Humans; Neoplasm Staging; Thoracic Surgery, Video-Assisted; Thymoma; Thymus Neoplasms; Treatment Outcome
PubMed: 18640366
DOI: 10.1016/j.athoracsur.2008.03.055 -
Surgery Today 2005When dealing with tumors of the thymus and mediastinum, both the surgeon and the pathologist are confronted with a vast variety of different pathohistologic entities,... (Review)
Review
When dealing with tumors of the thymus and mediastinum, both the surgeon and the pathologist are confronted with a vast variety of different pathohistologic entities, among which epithelial tumors, namely thymomas and thymic carcinomas, are the most frequent. Intimate knowledge of the different entities and their anticipated clinical outcome is required to meet diagnostic and therapeutic challenges. We herein briefly update the reader with the most important new changes in the 2004 WHO classification of tumors of the thymus and to important new trends in the treatment of some of these tumors.
Topics: Female; Humans; Male; Sensitivity and Specificity; Terminology as Topic; Thymoma; Thymus Neoplasms; World Health Organization
PubMed: 16175459
DOI: 10.1007/s00595-005-3047-y -
Cancer Radiotherapie : Journal de La... Nov 2005Thymomas and thymic carcinomas are rare and slow-growing tumors, which develop within the anterior mediastinum. Thymomas are often associated with autoimmune disorders... (Review)
Review
Thymomas and thymic carcinomas are rare and slow-growing tumors, which develop within the anterior mediastinum. Thymomas are often associated with autoimmune disorders and most particularly myasthenia gravis. The treatment of choice remains a complete surgical resection. Postoperative radiotherapy is often combined in case of invasive thymoma invading into adjacent organs. Postoperative radiotherapy in stage II with invasion into capsule has been more controversial lately. In inoperable locally advanced, or metastatic thymic tumors, neoadjuvant cisplatin-based followed by surgery and radiotherapy has given interesting results in the past years.
Topics: Carcinoma; Chemotherapy, Adjuvant; Humans; Neoplasm Invasiveness; Prognosis; Radiotherapy, Adjuvant; Thymoma; Thymus Neoplasms
PubMed: 16168694
DOI: 10.1016/j.canrad.2005.07.004 -
Journal of Thoracic Oncology : Official... Sep 2010The potential benefits and long-term complications of radiotherapy treatment for malignant thymoma are unclear. This is a retrospective analysis of outcome in patients...
INTRODUCTION
The potential benefits and long-term complications of radiotherapy treatment for malignant thymoma are unclear. This is a retrospective analysis of outcome in patients with malignant thymoma from the Surveillance, Epidemiology, and End Results database between 1973 and 2005.
METHODS
Of the 1987 patients identified, 1334 were analyzed. Patients were categorized according to the Masaoka staging system as stage I to IIA, IIB or III to IV. The primary end points were overall survival, cardiac mortality, and the development of secondary malignancies.
RESULTS
Patients received surgery and radiation (50%), surgery alone (26%), radiation alone (12%), or no treatment (12%). The median follow-up time for survivors was 65 months (range, 1-361 months). There was no significant increase in the 12-year cumulative incidence rate of death from heart disease (10.2% radiation versus 7.5% no radiation, p = 0.83) or incidence of secondary malignancies (11.7% versus 12.4%, p = 0.70) with radiation. Compared with surgery alone, adjuvant radiation significantly improved overall survival in patients with stage III to IV disease (p = 0.04) and demonstrated a nonsignificant trend in patients with stage IIB disease (p = 0.09). However, after excluding patients surviving less than 4 months to account for surgical mortality, the benefit with radiation was no longer significant (stage IIB: p = 0.45, stage III-IV: p = 0.44).
CONCLUSIONS
Radiation does not seem to increase the risk of cardiac mortality or secondary malignancy in patients with malignant thymoma. Although the routine use of postoperative radiotherapy in malignant thymoma does not appear warranted, high-risk patients may benefit from adjuvant radiation. This study can help to design prospective trials to further establish the role of radiotherapy in malignant thymoma.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Female; Humans; Male; Middle Aged; Neoplasm Staging; Postoperative Period; Radiotherapy, Adjuvant; Retrospective Studies; SEER Program; Survival Rate; Thymectomy; Thymoma; Thymus Neoplasms; Treatment Outcome; Young Adult
PubMed: 20651611
DOI: 10.1097/JTO.0b013e3181e8f345 -
Critical Reviews in Oncology/hematology Feb 2008Thymoma is a rare neoplasm usually with an indolent growth pattern, however, local invasion and/or metastases may occur. The association with several paraneoplastic... (Review)
Review
Thymoma is a rare neoplasm usually with an indolent growth pattern, however, local invasion and/or metastases may occur. The association with several paraneoplastic syndromes, especially myasthenia gravis, is noteworthy. Surgery has been the standard of care for early stage disease with high cure rates anticipated. The most important prognostic factors after resection are Masaoka stage, World Health Organization (WHO) histology, complete resection status and size. Multimodality therapy can result in long-term disease-free survival for patients presenting with locally advanced disease. Thymomas are sensitive to both chemotherapy and radiation therapy and are utilized with good effects in unresectable patients.
Topics: Autoimmune Diseases; Diagnosis, Differential; Humans; Neoplasm Staging; Paraneoplastic Syndromes; Prognosis; Survival Rate; Thymoma; Thymus Neoplasms
PubMed: 17570676
DOI: 10.1016/j.critrevonc.2007.04.005 -
BMC Research Notes Apr 2018Thymomas generally arise from the thymus in the anterior mediastinum. Ectopic thymomas arising in the middle mediastinum are rare. We present a case of a thymoma arising... (Review)
Review
BACKGROUND
Thymomas generally arise from the thymus in the anterior mediastinum. Ectopic thymomas arising in the middle mediastinum are rare. We present a case of a thymoma arising from the ectopic thymic tissue in the right paratracheal region.
CASE PRESENTATION
The patient was a 67-year-old male who underwent an enhanced-computed tomography examination as preoperative staging for colon cancer. A 20-mm nodule in the right paratracheal region was found incidentally. Fluorodeoxyglucose (FDG) accumulation was detected in this solitary nodule by FDG-positron emission tomography, mimicking an enlarged, possibly malignant lymph node. The tumor was removed by thoracoscopic surgery, and a postoperative pathological diagnosis of type AB thymoma was made. Foci of ectopic thymic tissues were found adjacent to the thymoma. The patient was disease-free and without recurrence 2 years postoperatively.
CONCLUSIONS
Including the present case, 13 cases of ectopic paratracheal thymoma have been reported in the English literature, all of which were found on the right side of the paratracheal region. Although ectopic thymomas in the paratracheal region are rare, thymomas may be considered as a differential diagnosis for a paratracheal nodule.
Topics: Aged; Humans; Male; Mediastinum; Positron-Emission Tomography; Thoracoscopy; Thymoma; Thymus Neoplasms
PubMed: 29695275
DOI: 10.1186/s13104-018-3359-9 -
Clinical Cardiology Aug 1995Thymomas are tumors of the anterior mediastinum. They are most often seen in adults aged 45 to 50 years. These tumors are routinely asymptomatic for prolonged periods of...
Thymomas are tumors of the anterior mediastinum. They are most often seen in adults aged 45 to 50 years. These tumors are routinely asymptomatic for prolonged periods of time. The most common presentation is discovery on routine chest x-ray. We therefore present a case report of an elderly woman who presented with symptoms of dyspnea caused by a malignant thymoma. To our knowledge, symptomatic pericardial tamponade due to a thymoma with a massive pericardial effusion has not been described previously.
Topics: Aged; Cardiac Tamponade; Dyspnea; Female; Humans; Pericardial Effusion; Thymoma; Thymus Neoplasms
PubMed: 7586769
DOI: 10.1002/clc.4960180813 -
Cancer Mar 1988To determine the histologic grade of malignancy of thymoma, the nuclear areas of epithelial cells of 42 thymomas, 14 thymic hyperplasias, and ten normal thymuses were...
To determine the histologic grade of malignancy of thymoma, the nuclear areas of epithelial cells of 42 thymomas, 14 thymic hyperplasias, and ten normal thymuses were measured by morphometry and the results were compared with the extent of disease, association with myasthenia gravis (MG), and histologic subtypes of the thymomas. The nuclei of epithelial cells of thymomas were significantly larger than those of both of thymic hyperplasias and normal thymuses (P less than 0.01). The nuclei of epithelial cells of invasive thymomas were significantly larger than those of noninvasive ones (P less than 0.001). In the noninvasive group, the nuclei of epithelial cells of thymomas associated with MG were significantly larger than those without MG (P less than 0.02), and were similar to those of invasive thymomas. These results confirm that invasive thymomas are morphometrically malignant tumors, and suggest that noninvasive thymomas associated with MG might have malignant potential.
Topics: Adolescent; Adult; Aged; Epithelium; Female; Humans; Male; Middle Aged; Myasthenia Gravis; Neoplasm Staging; Thymoma; Thymus Gland; Thymus Hyperplasia; Thymus Neoplasms
PubMed: 3338061
DOI: 10.1002/1097-0142(19880301)61:5<982::aid-cncr2820610521>3.0.co;2-1 -
Histopathology Jan 2024The epithelial and lymphoid compartments of the thymus can give rise to a wide variety of tumours, including thymomas, thymic carcinomas, lymphoreticular proliferations,... (Review)
Review
The epithelial and lymphoid compartments of the thymus can give rise to a wide variety of tumours, including thymomas, thymic carcinomas, lymphoreticular proliferations, germ cell tumours, and sarcomas. While some of these have close similarity to their counterparts in other organs, both in terms of histology and immunohistochemistry, as well as molecular features, others are unique to the thymus. The epithelial tumours, which can develop in the thymus, will be discussed in this review, with a particular emphasis on resolving differential diagnosis by means of morphology, immunohistochemical profiles, and molecular diagnostics.
Topics: Humans; Diagnosis, Differential; Thymus Neoplasms; Thymoma; Neoplasms, Glandular and Epithelial
PubMed: 37994555
DOI: 10.1111/his.15097