Ectopic thymoma presenting as a giant intrathoracic mass: A Case Report

Takenaka, Tomoyoshi; Ishida, Tatsuhiro; Handa, Yoshinori; Tsutsui, Shinichi; Matsuda, Hiroyuki

doi:10.1186/1749-8090-7-68

“…Eighty percent of type A thymomas are Masaoka-Koga stage I on presentation (for explanation on the Masaoka-Koga staging system, see paragraph on staging). Stage IV is rare in this histological subtype [1,3]. The prognosis of type A thymoma is excellent with 5-and 10-year survival rates close to 100% [10].…”

Section: Who Histological Classificationmentioning

confidence: 98%

“…Seventy-two percent is Masaoka-Koga stage I at presentation, 22% stage II, and 6% stage III. As in WHO type A disease, stage IV is rare [1]. Overall 5-and 10-year survival is reported 80-100% for stages I and II.…”

Section: Who Histological Classificationmentioning

confidence: 99%

“…Numerous classifications for thymic neoplasms, based on different histological and clinical criteria, have been proposed in the past. For universal agreement purposes, the International Committee of the World Health Organization (WHO) developed a classification system that distinguishes five histological subtypes of thymomas that differ in both morphological and clinical presentation and which correlate with invasion [1]. The WHO classification is increasingly more malignant from A to B3.…”

Section: Who Histological Classificationmentioning

confidence: 99%

“…In 5-15% of cases, they are non-resectable, and recurrence rates are 9% after complete resection [10,12]. Reported 10-year survival rates are between 50 and 100% [1].…”

Section: Who Histological Classificationmentioning

confidence: 99%

“…If this is diagnosed, treatment is essential, as myasthenia gravis can cause a postoperative myasthenic crisis or respiratory failure [38]. Thymoma Masaoka-Koga stages I and II have a 5-year survival rate of 100% after surgery [1]. In the case of an incomplete resection, postoperative radiotherapy (PORT), either on the primary tumor or on isolated metastasis, is recommended to reduce the risk of recurrence [35,39].…”

Section: Resectable Diseasementioning

confidence: 99%

See 3 more Smart Citations

Thymoma and Thymic Carcinoma

2015

The SAGE Encyclopedia of Cancer and Society

57

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Malignancies of the thymus are a rare entity and are often without local symptoms. However, paraneoplastic syndromes can give symptoms varying from very mild to life-threatening. The diagnostic workup and management of these tumors warrant a multidisciplinary approach. Treatment choice is mainly decided upon by pathological World Health Organization (WHO) subtype and clinical staging. In contrast to historical belief, biopsy could be considered when indicated. For resectable tumors, surgical approach is advised, with adjuvant radiotherapy for Masaoka-Koga stage III tumors. Whether Masaoka-Koga stage II tumors should be treated with radiotherapy is controversial given different outcomes in multiple studies. In Masaoka-Koga stage III, combinations with induction chemotherapy are the standard. A surgical approach should be considered even in stage IVa disease. If distant metastases are present, the patient can be treated with systemic chemotherapy. Despite many phase II studies having been published, there is no randomized controlled phase III data regarding optimal treatment available. In addition to chemotherapy, sunitinib and octreotide have been described to be effective. Immunotherapy is seen as Pandora's box given the possibility of immune-related side effects in this immunological organ. All known data regarding immunotherapy will be discussed.

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Thymoma and Thymic Carcinoma

2016

Diagnostic Imaging: Nuclear Medicine

0

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Malignancies of the thymus are a rare entity and are often without local symptoms. However, paraneoplastic syndromes can give symptoms varying from very mild to life-threatening. The diagnostic workup and management of these tumors warrant a multidisciplinary approach. Treatment choice is mainly decided upon by pathological World Health Organization (WHO) subtype and clinical staging. In contrast to historical belief, biopsy could be considered when indicated. For resectable tumors, surgical approach is advised, with adjuvant radiotherapy for Masaoka-Koga stage III tumors. Whether Masaoka-Koga stage II tumors should be treated with radiotherapy is controversial given different outcomes in multiple studies. In Masaoka-Koga stage III, combinations with induction chemotherapy are the standard. A surgical approach should be considered even in stage IVa disease. If distant metastases are present, the patient can be treated with systemic chemotherapy. Despite many phase II studies having been published, there is no randomized controlled phase III data regarding optimal treatment available. In addition to chemotherapy, sunitinib and octreotide have been described to be effective. Immunotherapy is seen as Pandora's box given the possibility of immune-related side effects in this immunological organ. All known data regarding immunotherapy will be discussed.

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Giant thymoma presenting as a large bilateral intrathoracic mass: A case report and a comparison between median sternotomy and hemiclamshell approach

Daoud

¹

,

Darwish

²

,

Zahra

³

et al. 2021

Annals of Medicine and Surgery

1

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Introduction Thymoma is an epithelial tumor that commonly lies in the anterior mediastinum. It rarely extends to the pleural cavities. There is no standard approach for resecting similar giant thymomas. Case presentation An eighteen-year-old woman presented with a six-month history of progressive exertional dyspnea, weight loss, and loss of appetite. Radiological imaging demonstrated a giant mediastinal mass extending to both pleural cavities, a transthoracic needle biopsy was then performed, which indicated thymic hyperplasia. Clinical discussion The tumor was completely resected using a two-step approach, starting with a median sternotomy then extending it to a hemiclamshell incision, which provided better exposure of the tumor and caused less morbidity. The left part of the thymoma was resected using a median sternotomy, which took a relatively long time and caused significant blood loss. Then the incision was extended to a hemiclamshell incision through the pleural cavity to remove the right part of the tumor. This approach helped us to visualize the tumor better and did not cause any significant blood loss. The removed mass measured 36 × 29 × 10 cm and weighed 4500 g. Pathologic diagnosis indicated a type B1 tumor with no capsular invasion according to the World Health Organization classification. Conclusion The hemiclamshell approach is superior to the median sternotomy incision in resecting giant thymomas extending to the pleural cavity, as it saves time and causes less morbidity.

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Ectopic thymoma presenting as a giant intrathoracic mass: A Case Report

Cited by 11 publications

References 7 publications

Thymoma and Thymic Carcinoma

Thymoma and Thymic Carcinoma

Thymoma and Thymic Carcinoma

Giant thymoma presenting as a large bilateral intrathoracic mass: A case report and a comparison between median sternotomy and hemiclamshell approach

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