Tumors of the Thymus and Thymic Region: I. Clinicopathological Studies on Thymomas

Bergh, Niklas; Gatzinsky, P; Larsson, Sture; Lundin, Per; Ridell, Børje

doi:10.1016/s0003-4975(10)63498-4

Cited by 192 publications

(63 citation statements)

References 16 publications

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“…Several studies of thymoma patients reported frequent occurrence of second malignancies at diverse sites including breast, colon, leukemia and non-Hodgkin lymphoma, and carcinoid tumors. [10][11][12][13] Bergh et al, 14 in 1978, recognized that all thymic tumors can manifest malignant behavior and should be considered as malignant diseases. This is consistent with our findings that thymic tumors of all histologic types were associated with metastases, albeit with different frequencies.…”

Section: Discussionmentioning

confidence: 99%

Extrathoracic metastases of thymic origin: a review of 35 cases

et al. 2012

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Thymic tumors are categorized as types A, AB, B1, B2, B3, and thymic carcinoma under the World Health Organization (WHO) classification. Thymomas are typically slow growing tumors that predominantly involve the surrounding structures through direct invasion, while thymic carcinomas tend to be more aggressive. A significant number of patients are asymptomatic and can present with metastases as the first presentation. The exact incidence of extrathoracic metastases from thymoma is not known. This study describes a series of 35 cases of histologically documented metastatic thymomas and thymic carcinomas at extrathoracic sites. These cases were classified according to the current World Health Organization (WHO) classification criteria, and we present their clinical data as well as discuss the differential diagnoses of these lesions. Our study shows that all types of thymic tumors, regardless of histologic type, can be associated with invasion and metastases to thoracic and extrathoracic sites. It is the most aggressive variant invading surrounding structures with metastases, 2 although embolic metastases of thymic carcinoma leading to extrathoracic metastases are very rare. 4 Since, thymic cancers invade locally, diagnoses of metastases are difficult. Locally advanced thymic tumors often present as pleural plaques, which can be misdiagnosed as lung metastases on imaging studies. Thus, it becomes very important to appropriately define metastases in these tumors. For this reason, we defined only lesions outside the thorax that were histologically similar to the primary thymic tumors as metastases.Although the exact incidence of extrathoracic metastases from thymoma is not known, in 1983, Ichino et al 5 documented 83 cases in the literature. However, most of the metastatic sites were not biopsied and histology was not available. In addition, the older literature does not make a distinction between epithelial lesions (true thymic tumors) and other neoplasms arising in the region of thymus. In any event, these studies suggest liver, bone, and lymph nodes as common sites of extrathoracic metastases of malignant thymoma. [4][5][6] Moreover,

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Section: Discussionmentioning

confidence: 99%

Extrathoracic metastases of thymic origin: a review of 35 cases

et al. 2012

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“…In our patient, we were unable to isolate an organism and it is possible that part of his fever was secondary to the thymoma [22,23]. In those who survived, their neutropenias responded initially to prednisone then thymectomy [7], but thymectomy was not effective in another case [5].…”

Section: Discussionmentioning

confidence: 99%

Pure Neutrophil Aplasia Associated with Thymoma

Al-Mohareb

1992

Ann Saudi Med

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“…Bergh et al (17) (16). Several reports have shown that the oncological outcomes significantly correlated with Masaoka stages (16,(20)(21)(22)(23).…”

Section: Clinical Stagementioning

confidence: 99%

Surgical and oncological outcomes of thoracoscopic thymectomy for thymoma

Odaka¹,

Tsukamoto²,

Shibasaki³

et al. 2017

J. Vis. Surg.

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type classification are valuable predictors of the prognosis of thymoma; hence, the optimal treatment for thymoma should be performed according to these two. TT is less invasive, with equivalent oncological outcomes, when compared with the OT. Minimally invasive surgery including TT for stage I-II thymomas is becoming the mainstay of therapy. (16,(20)(21)(22)(23). In our previous study (24), Masaoka stage III-IV thymoma patients experienced more recurrences than those with stage I-II patients. The 5-year disease-free survival (DFS) for stage III-IV thymomas was significantly poorer than those for stage I and II thymoma (47% vs. 97.5% and 94.1%, respectively). Hence, the Masaoka stage was a valuable predictor of the prognosis of thymoma. Keywords Pathologic classificationThe pathologic classification of thymoma has remained controversial for many years (25). The World Health Organization (WHO) has developed the most widely adopted pathologic classification for epithelial tumor of thymus by taking into consideration both histological and morphological features (26). There are two staging systems for epithelial tumor of thymus (27). Most widely used clinical stage was first described by Masaoka et al. in 1981, and it is a clinical staging system describing thymomas in terms of local extension or invasion of the tumor (6). The TNM staging follows the pattern of T for tumor descriptor, N for nodal spread, and M for distance metastasis. In 1999, the WHO Consensus Committee published a histologic typing system for neoplasms of the thymus (28). Thymomas are classified into types A, AB, B1, B2, B3, and C based on the morphology of epithelial cells and ratio of lymphocyteto-epithelial cells. Recently, the WHO Consensus Committee recommended that epithelial tumors of thymus be classified as thymoma, including type A, AB, B1, B2, and B3 thymoma and thymic carcinoma (29). Most of the WHO type A, AB, B1, and B2 thymomas are benign; however, types B3 and C have malignant potential (30). Our study (24) demonstrated that 16 of 140 thymomas patients experienced recurrences. Of those 16 patients, 12 patients had WHO type B3 or C thymomas. Thus, pathological aggressiveness seems to strongly influence recurrence. Several reports have indicated the impact of the WHO type on the decisionmaking during clinical treatments (26). Surgical treatmentMost patients having Masaoka stage I-II thymoma receive surgical treatment. Recently, TT has been attempted as a surgical treatment for thymoma. TT for thymoma consists of extended thymectomy (ET), total thymectomy, subtotal thymectomy (STT), and partial thymectomy according to the classification of the extent of the thymus resected. In this review, a few authors classified thymectomy by total and partial thymectomy, while some authors do not describe the resected extent of thymus clearly. Total thymectomy was defined as the resection of the entire thymus, and ET was defined as the resection with the thymus and surrounding fat tissues together. ET was usually performed in patients who had MG. F...

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Tumors of the Thymus and Thymic Region: I. Clinicopathological Studies on Thymomas

Cited by 192 publications

References 16 publications

Extrathoracic metastases of thymic origin: a review of 35 cases

Extrathoracic metastases of thymic origin: a review of 35 cases

Pure Neutrophil Aplasia Associated with Thymoma

Surgical and oncological outcomes of thoracoscopic thymectomy for thymoma

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