Paraneoplastic Syndromes and Thymic Malignancies: An Examination of the International Thymic Malignancy Interest Group Retrospective Database

Padda, Sukhmani K.; Yao, Xiaopan; Antonicelli, Alberto; Riess, Jonathan W.; Shang, Yue; Shrager, Joseph B.; Korst, Robert J.; Detterbeck, Frank C.; Huang, James; Burt, Bryan M.; Wakelee, Heather A.; Badve, Sunil

doi:10.1016/j.jtho.2017.11.118

Cited by 77 publications

(78 citation statements)

References 45 publications

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“…In the study by Padda et al . 33.0% of patients with thymomas had MG, which was similar to the incidence observed in the ITMIG database . However, thymomas located in the superior mediastinum were more frequently associated with MG than those located in the inferior mediastinum.…”

Section: Discussionsupporting

confidence: 78%

“…In the study by Padda et al 33.0% of patients with thymomas had MG, which was similar to the incidence observed in the ITMIG database. 31 However, thymomas located in the superior mediastinum were more frequently associated with MG than those located in the inferior mediastinum. There is no consensus on the pathophysiological link between thymomas and MG. 32 However, previous studies have demonstrated a correlation between MG and anti-AChR antibodies.…”

Section: Discussionmentioning

confidence: 95%

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Tumor location may affect the clinicopathological features and prognosis of thymomas

et al. 2019

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Background The current staging systems do not consider the tumor location of thymomas, and its clinical relevance is poorly understood. This study aimed to evaluate the impact of tumor location on the clinicopathological features and prognosis of thymomas. Methods We performed a retrospective review of patients at our institution who underwent an extended thymectomy for a thymoma from 1976 to 2015. The tumor location was classified as either the superior or inferior mediastinum based on the maximum tumor diameter. The clinicopathological characteristics of the thymoma were also evaluated. Kaplan‐Meier estimates and Cox proportional hazards models were used to analyze the survival outcomes and risk factors for recurrence. Results A total of 194 patients with thymoma were eligible for this study. Compared with the inferior mediastinum group (n = 167), the superior mediastinum group (n = 27) had a higher frequency of myasthenia gravis (MG), advanced Masaoka‐Koga staging, disease progression and recurrence (P < 0.05). The Kaplan‐Meier analysis demonstrated thymomas in the superior mediastinum had worse survival outcomes that included overall survival, progression‐free survival and disease‐free survival (P < 0.05). The multivariate analysis showed tumor location was an independent prognostic factor for all the survival outcomes (P < 0.05). Furthermore, the tumor location (P = 0.004) and Masaoka‐Koga stage (P < 0.001) were the only two independent risk factors for recurrence in the multivariate analysis. Conclusions The clinicopathological features of thymomas on MG, Masaoka‐Koga staging, disease progression, and recurrence were different between locations of superior and inferior mediastinum locations. Thymomas in the superior mediastinum tended to be associated with worse survival and increased recurrence.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 95%

Tumor location may affect the clinicopathological features and prognosis of thymomas

et al. 2019

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“…Thymic epithelial tumors are comprised of two different tumor types including thymomas and thymic carcinomas [9,18]. While thymomas are rare, they remain the most common mediastinal mass in adults, comprising up to 25% of mediastinal masses [2].…”

Section: Discussionmentioning

confidence: 99%

“…While it is well-recognized that these diseases may occur in the absence of a thymoma, the presence of a thymoma has been associated with a worse prognosis, which in some part, appears to be dependent on thymoma WHO classification and Masaoka staging [1-3, 9, 10]. In a large retrospective analysis, Padda et al noted that among different WHO thymoma classes, class B2 is most commonly associated with autoimmune and paraneoplastic disorders, whereas class AB thymomas are least commonly associated [9]. Furthermore, they noted that the presence of an autoimmune or neoplastic syndrome was not an independent prognostic factor for recurrence-free and overall survival in thymic epithelial tumors.…”

Section: Discussionmentioning

confidence: 99%

A tale of autoimmunity: thymoma, thymectomy, and systemic lupus erythematosus

Mollaeian

Haas

2020

Clin Rheumatol

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The thymus plays an integral role in immune system regulation, modulating the development, diversity, and selection of T lymphocytes, a critical feature for the prevention of T cell-mediated autoimmunity. Thymoma is a rare tumor of the thymus. Autoimmune diseases and paraneoplastic syndromes such as myasthenia gravis, pure red blood cell aplasia, and systemic lupus erythematosus, although relatively uncommon, have been described in association with thymomas. Rare cases of postthymectomy autoimmune related diseases, including systemic lupus erythematosus and pure red cell aplasia, have been reported in the literature. Here, we present the case of a 65-year-old male who developed systemic lupus erythematosus 2 years after thymectomy in the setting of thymoma-associated pure red cell aplasia.

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“…Patients with thymic neoplasms might be clinically indolent or present with thoracic symptoms. A wide range of autoimmune parathymic syndromes associated with thymic neoplasms has been reported . Myasthenia gravis is the most common parathymic syndrome in thymic neoplasm patients, followed by pure red cell aplasia and adult‐onset hypogammaglobulinemia.…”

Section: Introductionmentioning

confidence: 99%

Thymic neoplasms patients complicated with bronchiectasis: Case series in a Chinese hospital and literature review

Liu

Tian

et al. 2019

Thoracic Cancer

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Background Bronchiectasis is a rare complication in patients with thymic neoplasm. The aim of this study was to investigate the clinical and radiological manifestations, laboratory tests, pathologic features, and outcome of treatment of bronchiectasis in patients with thymic neoplasm. Methods From January 2000 to January 2018, 20 patients with a diagnosis of thymic neoplasm and bronchiectasis were hospitalized at the Peking Union Medical College Hospital. Clinical data was retrospectively analyzed. Results The prevalence of bronchiectasis in thymic neoplasms in our cohort was 1.56% (20/1279). Eighteen patients were diagnosed with thymoma, while two patients were diagnosed with thymic carcinoid. The duration from diagnosis of thymic neoplasm to bronchiectasis varied. Distributions of bronchiectasis were bilateral in 17 patients and unilateral in three patients. Four patients were previously diagnosed with diffuse panbronchiolitis and another two were suspected with diffuse panbronchiolitis. Twelve patients had various parathymic syndromes, including Good syndrome, myasthenia gravis, and aplastic anemia. Thymectomy was performed in all of these patients. Macrolide antibiotics were administered to 10 patients, and the symptoms improved in 8. Conclusion Bronchiectasis is a complication in thymic neoplasms, although prevalence is low. There may be multifactorial etiologies for bronchiectasis in patients with thymic neoplasms. Comprehensive treatment should be carried out to ensure optimal outcomes.

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Paraneoplastic Syndromes and Thymic Malignancies: An Examination of the International Thymic Malignancy Interest Group Retrospective Database

Cited by 77 publications

References 45 publications

Tumor location may affect the clinicopathological features and prognosis of thymomas

Tumor location may affect the clinicopathological features and prognosis of thymomas

A tale of autoimmunity: thymoma, thymectomy, and systemic lupus erythematosus

Thymic neoplasms patients complicated with bronchiectasis: Case series in a Chinese hospital and literature review

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