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Clinical presentation and management of thymoma and thymic carcinoma

Avedis Meneshian, MD
Giuseppe Giaccone, MD, PhD
Kenneth R Olivier, MD
Section Editors
Joseph S Friedberg, MD
James R Jett, MD
Rogerio C Lilenbaum, MD, FACP
Steven E Schild, MD
Deputy Editor
Sadhna R Vora, MD


Thymic tumors are rare neoplasms that arise in the anterior mediastinum. The clinical presentation, diagnosis, staging, and management of thymoma and thymic carcinoma are reviewed here.

The initial approach to patients with an anterior mediastinal mass is discussed separately. (See "Approach to the adult patient with a mediastinal mass".)


The thymus is an anterior mediastinal organ that weighs 12 to 15 grams at birth, reaches its maximum weight of about 40 grams around puberty, and then involutes and persists in an atrophic state into old age.

The thymus is composed of an outer cortex consisting primarily of epithelial cells, degenerated keratinized epithelial cells (Hassall's corpuscles), myoid cells, thymic lymphocytes ("thymocytes"), and B-lymphocytes, which form rare germinal centers. The thymus is primarily involved in the processing and maturation of lymphocytes, which become T-lymphocytes upon release into the circulation.


In adults, thymomas and thymic carcinomas are the most common neoplasms arising in the thymus. Thymomas account for about 20 percent of mediastinal neoplasms (table 1). Most thymoma patients are between 40 and 60 years of age, and there is a similar incidence in men and women [1]. There are no known risk factors, although there is a strong association with myasthenia gravis and other paraneoplastic syndromes.


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Literature review current through: May 2017. | This topic last updated: Jul 15, 2016.
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