Pericardial involvement by thymomas

Abstract

Thymomas are usually found in the anterior mediastinum, the normal location of the thymus. Involvement of the pericardium by thymic tumors is seen in invasive or metastasized thymoma. Very rarely, thymomas arise primarily in the pericardium. These tumors are believed to derive from thymic tissue which was misplaced in the pericardium during embryologic development. In contrast to patients with orthotopic thymoma who commonly suffer from paraneoplastic diseases, especially myasthenia gravis, patients with intrapericardial thymoma manifestations mainly have symptoms of congestive heart failure which are caused by local complications of tumor growth. In this study, we present two cases of thymoma involving the pericardium. Both tumors were polygonal-oval cell thymomas. In one of the cases diagnosis of an entirely intrapericardial thymoma was established by autopsy. In the other case, explorative thoracotomy revealed massive pericardial and pleural tumor manifestations. The latter tumor showed a peculiar histological pattern with multiple glomeruloid bodies, a finding reported only once for thymomas.

Long-Term Outcomes of Thymoma Treated at a Single Institute

“…5 Paraneoplastic syndromes (PNSs) may antedate the diagnosis of thymoma or be diagnosed concurrently, with myasthenia gravis (MG) being the commonest PNS. Up to 20% of MG patients have thymoma and 30 to 50% of thymoma patients have thymoma-associated MG. 6 Although known to exhibit local invasion (pleural, pericardial), 7,8 thymomas seldom spread to draining lymphatics, owing to lack of afferent lymphatics. 9 The mainstay of treatment is surgery (total thymectomy and excision of tumor) for operable patients, and completeness of resection is considered a key predictor of outcome.…”

Metastasis of a Malignant Thymoma Presenting as a Right Atrial Mass

“… 1 - 3 In regard to the heart, the metastatic involvement of the pericardium, the superior vena cava, and the RA by malignant thymomas has been reported. 4 , 5 Accordingly, in the evaluation of patients with a history of malignant thymomas and cardiac masses, tumor metastasis should be considered in the differential diagnosis.…”