Thymic Neoplasms: A Comprehensive Review of the Diagnosis, Classification, and Treatment

Frank Detterbeck, Sarah Counts, Edith M Marom

Key Points

  • International collaborative organizations have dramatically expanded the knowledge base regarding thymic malignancies
  • A reliable clinical diagnosis of thymic malignancy is usually possible for an experienced clinician on the basis of demographic features, radiographic characteristics and the clinical presentation
  • All thymomas are malignant (but often only slowly progressive)
  • Thymomas are frequently associated with a wide variety of autoimmune and neurologic syndromes (most commonly myasthenia gravis)
  • Thymic carcinoma and neuroendocrine tumors of the thymus are more aggressive than thymoma
  • Complete surgical resection is the main treatment intervention
  • The role of postoperative radiotherapy after complete resection is unclear
  • Multimodality treatment (e.g. preoperative chemo(radio)therapy, complete resection, adjuvant radiotherapy) for thymic malignancies that are locally advanced or manifest pleural dissemination yields reasonable long-term results
  • Several active chemotherapy regimens have been identified
  • When possible, resection of recurrence (plus chemo- or radiotherapy) results in reasonable long-term outcomes

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Last updated: January 5, 2021