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Clinical presentation and management of thymoma and thymic carcinoma

Authors
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

INTRODUCTION

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 pathology of thymic carcinomas, the initial approach to patients with an anterior mediastinal mass, and diagnosis and management of thymic neuroendocrine tumors is discussed separately. (See "Pathology of mediastinal tumors", section on 'Thymoma' and "Pathology of mediastinal tumors", section on 'Thymic carcinoma' and "Approach to the adult patient with a mediastinal mass" and "Thymic neuroendocrine (carcinoid) tumors".)

EPIDEMIOLOGY

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.

CLINICAL PRESENTATION

Thymomas and thymic carcinomas typically present in one of three major ways:

As an incidental finding identified on imaging in an asymptomatic patient (image 1)

                    
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Literature review current through: Sep 2017. | This topic last updated: Aug 30, 2017.
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