Thymoma

Rare Cancer

Category: 呼吸器ICD-10: C37

Overview

Thymoma and thymic carcinoma are tumors of the thymus gland in the anterior mediastinum. They are classified by WHO into types A, AB, B1, B2, B3, and thymic carcinoma. About 30% of thymoma patients develop myasthenia gravis as a paraneoplastic condition.

Symptoms

Many cases are asymptomatic and discovered incidentally on chest imaging. Advanced tumors may cause chest pain, cough, superior vena cava syndrome, or myasthenia gravis symptoms (ptosis, diplopia, muscle weakness).

Diagnosis

Chest CT identifies an anterior mediastinal mass, and contrast-enhanced CT or MRI assesses invasion of surrounding structures. Needle biopsy or surgical pathology is required for definitive diagnosis.

Treatments

Complete surgical resection is the most important treatment for thymoma, with adjuvant radiation based on Masaoka staging. Unresectable cases receive cisplatin-based chemotherapy (ADOC regimen). Thymic carcinoma is treated with carboplatin plus paclitaxel.

Latest Research & Approaches

Lenvatinib and pembrolizumab have shown efficacy in unresectable or recurrent thymic carcinoma in clinical trials. Caution is needed regarding potential immune-related autoimmune complications.

Sources & References

NCI - Thymoma and Thymic Carcinoma Treatment
American Cancer Society - Thymus Cancer
NCCN Guidelines: Thymomas and Thymic Carcinomas