Thymic tumors including thymomas, thymic carcinomas, and thymic carcinoid tumors, are relatively infrequent. These tumors with a wide spectrum of histological and biological features may exhibit an indolent clinical course (thymomas) or manifest an aggressive behavior (thymic carcinoma) with a high risk of relapse and metastasis. Successful management of these tumors depends on accurate diagnosis, thorough staging, proper assessment of patient health status, and selection of treatment modality. Surgery remains the mainstay of therapy whereas radiation therapy plays an important role in subtotally resected or unresectable cases. The risk of side effects and late sequelae is generally low when proper radiation technique is employed. This review examines the current role of radiation therapy in the management of these tumors.
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[Show abstract][Hide abstract]ABSTRACT: The treatment of locally advanced Masaoka stage IVA thymoma is not standardized and is problematic.
A single-institution retrospective study was made of 5 patients with World Health Organization B3 thymomas who underwent pleuropneumonectomy for locally advanced thymoma. Two patients had recurrent thymoma and 3 presented de novo with stage IVA disease. Patients had a variety of induction and adjuvant treatments.
There was no operative mortality, and only 1 patient had a major complication. Several patients had relatively prolonged disease-free survival. The median survival was 86 months, and the Kaplan-Meier survival was 75% (95% confidence interval: 53% to 97%) at 5 years and 50% (95% confidence interval: 25% to 75%) at 10 years.
Pleuropneumonectomy can be performed safely in patients with advanced thymomas and may improve survival. Highly selected patients might be cured with this approach if a complete resection is performed. While the optimal multimodality strategy for these patients is unknown, induction chemotherapy followed by resection then chemoradiotherapy seems promising.
Preview · Article · Nov 2006 · The Annals of thoracic surgery
[Show abstract][Hide abstract]ABSTRACT: A 48-year-old woman was diagnosed with a giant, 20 x 18 x 9 cm, right-sided thymoma. A right posterolateral thoracotomy was performed to resect this lesion. The pathological diagnosis revealed a stage I thymoma according to Masaoka et al. . Although, in general, a sternotomy approach is preferred for thymectomies, because of its sheer size, this tumor was approached through a right thoracotomy. Recurrent thymomas originating from remnants of the thymus gland have been described in several individual case reports. Apart from these experiences, recent studies indicate a significant increase in the risk of recurrence for thymomas larger than 8 cm. In our patient, the remaining thymus gland portions were removed through a midline sternotomy. There is no information in the literature how often a thoracotomy has had to be chosen over a preferred sternotomy as the initial surgical procedure in order to resect a giant thymoma.
No preview · Article · Sep 2007 · The Thoracic and Cardiovascular Surgeon
[Show abstract][Hide abstract]ABSTRACT: Thymomas are common mediastinal tumours. We report a rare case of thymoma invasion into the superior vena cava with resultant venous obstruction. The tumour was resected. The superior vena cava and left brachiochephalic vein were reconstructed with autologous pericardial patch.
No preview · Article · Jan 2008 · Heart, Lung and Circulation