Management of thymomas.

Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Blake 1570, Boston, MA 02114, USA.
Critical Reviews in Oncology/Hematology (Impact Factor: 4.05). 03/2008; 65(2):109-20. DOI: 10.1016/j.critrevonc.2007.04.005
Source: PubMed

ABSTRACT 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.

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    ABSTRACT: A complete surgical resection represents the cornerstone of the therapy of the thymic tumours. Pleural disease may already be present at the diagnosis representing an advanced stage thymoma (Masaoka IVA) or it may appear during the follow-up, representing a pleural recurrence. The treatment of Stage IVA thymoma is quite examined in the medical literature; however just a few reports analysed the surgical treatment of thymoma recurrences, whose exclusive pleural recurrences represent more than 90%. Our aim was to review the literature laying the stress on the incidence, diagnosis, treatment options and prognosis of this highly selected group of patients with pleural recurrence from thymoma.
    European Journal of Cardio-Thoracic Surgery 05/2008; 33(4):707-11. DOI:10.1016/j.ejcts.2008.01.015 · 2.81 Impact Factor
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    ABSTRACT: We report a case of successful salvage surgery for invasive thymoma initially judged to be unresectable that did not respond to sequential chemoradiotherapy. The patient underwent en bloc resection of the tumor, superior vena cava, upper portion of the right atrium (RA) and intracardiac neoplastic thrombus with the aid of a cardiopulmonary bypass without cardiac arrest. The patient is disease free 8.5 years after radical thymectomy and subsequent resection of 2 second primary lung adenocarcinomas.
    Tumori 94(5):772-6. · 1.09 Impact Factor
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    ABSTRACT: Objective: To identify preoperative characteristics associated with complete surgical resection of primary malignant mediastinal tumors. Methods: Between 1996 and 2006, 42 patients with primary malignant mediastinal tumors were submitted to surgery with curative intent at a single facility. Patient charts were reviewed in order to collect data related to demographics, clinical manifestation, characteristics of mediastinal tumors and imaging aspects of invasiveness. Results: The surgical resection was considered complete in 69.1% of the patients. Cases of incomplete resection were attributed to invasion of the following structures: large blood vessels (4 cases); the superior vena cava (3 cases); the heart (2 cases); the lung and chest wall (3cases); and the trachea (1 case). Overall survival was significantly better among the patients submitted to complete surgical resection than among those submitted to incomplete resection. The frequency of incomplete resection was significantly higher in cases in which the tumor had invaded organs other than the lung (as identified through imaging studies) than in those in which it was restricted to the lung (47.6% vs. 14.3%; p = 0.04). None of the other preoperative characteristics analyzed were found to be associated with complete resection. Conclusions: Preoperative radiological evidence of invasion of organs other than the lung is associated with the incomplete surgical resection of primary malignant mediastinal tumors.