The most common anterior mediastinal tumours in adults.
Thymomas account for the vast majority of thymic neoplasms and are often associated with myasthenia gravis.
About 50% of thymic tumours are diagnosed on incidental finding. A chest CT with intravenous contrast is usually diagnostic.
Small encapsulated tumours are resected for both pathological diagnosis and treatment. Unresectable tumours are usually treated with induction therapy (chemotherapy ± radiotherapy) followed by reassessment for surgery. Patients with myasthenia gravis should have their myasthenia optimised before surgery.
Thymomas are relatively indolent tumours with high cure rates. Prognosis depends on Masaoka's stage, WHO histology, and resection status.
Thymic tumours are rare, although they are the most common anterior mediastinal tumours in adults. Thymomas account for the majority of thymic neoplasms. Common presenting symptoms include chest discomfort, cough, and muscle weakness involving ocular, facial, oropharyngeal and respiratory, and/or limb muscles due to associated myasthenia gravis. However, about 50% of thymic tumours are diagnosed as an incidental finding.
History and exam
Associate Professor of Clinical Medicine
Perelman Center for Advanced Medicine
University of Pennsylvania
TE has received consultancy fees from Genentech and Celgene. She is a board member of Wissahickon Hospice. Educational events include an annual thoracic educational series sponsored by Imedex.
Dr Tracey Evans would like to gratefully acknowledge Dr Nicholas Choong, Dr Mario Gasparri, and Dr Cameron Wright, previous contributors to this monograph. NC and MG declare that they have no competing interests. CW is an author of a number of references cited in this monograph.
Professor of Surgery
Division of Cardiothoracic Surgery
Department of Surgery
Indiana University School of Medicine
KK declares that he has no competing interests.
Assistant Attending Surgeon
Memorial Sloan-Kettering Cancer Center
JH is an author of a number of references cited in this monograph.
University of Torino
ER is an author of a reference cited in this monograph.
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