Primary thymus tumors: retrospective case analysis at a reference center in Latin America, 2011-2019

BMC Cancer. 2021 Mar 16;21(1):279. doi: 10.1186/s12885-021-07920-7.

Abstract

Background: Thymic tumors are unusual neoplasms, representing 0.2 to 1.5% of tumors in humans, but correspond to 20% of mediastinal tumors and 50% of those that occur in the anterior mediastinum. They tend to appear around the fourth and fifth decades of life without gender predilection. Up to 30% of patients are asymptomatic, therefore many are incidentally diagnosed. Radical thymectomy is the treatment of choice with high survival rates when detected in the early stages.

Methods: This was a retrospective descriptive study, including 18 adult patients' diagnosis of thymic neoplasm, who were managed with surgical resection from 2011 to 2019. Information about demographics, clinical characteristics, imaging findings, surgical and medical management, plus histological findings was obtained and reported.

Results: 18 patients with thymic tumors were included, of which specific histologic studies reveled thymomas, carcinomas, neuroendocrine tumors, thymolipoma and thymic cyst. Mean age was 52.7 years, with a predominance of male population. The main symptom was dyspnea, followed by cough and chest pain. Paraneoplastic syndromes such as myasthenia gravis, aplastic anemia and Cushing syndrome were reported. 89% of cases were treated by radical thymectomy alone, while only 2 cases required chemotherapy and radiotherapy. There were no surgical complications. Mean hospital stay length was 11. 9 days, with only 1 mortality during hospital admission. 5-year survival rate was 81%.

Conclusions: The treatment of choice is radical thymectomy, which has been shown to positively impact patient mortality. Early detection is key to improve patient outcomes.

Keywords: Radical thymectomy; Thymic carcinoma; Thymic neoplasm; Thymoma; Video-assisted thoracoscopy.

MeSH terms

  • Aged
  • Carcinoma / complications
  • Carcinoma / diagnosis
  • Carcinoma / mortality
  • Carcinoma / surgery
  • Colombia / epidemiology
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Lipoma / complications
  • Lipoma / diagnosis
  • Lipoma / mortality
  • Lipoma / surgery
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / complications
  • Neuroendocrine Tumors / diagnosis
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / surgery
  • Paraneoplastic Syndromes / epidemiology*
  • Paraneoplastic Syndromes / etiology
  • Retrospective Studies
  • Survival Rate
  • Thymectomy*
  • Thymoma / complications
  • Thymoma / diagnosis
  • Thymoma / mortality
  • Thymoma / surgery
  • Thymus Gland / diagnostic imaging
  • Thymus Gland / pathology*
  • Thymus Gland / surgery
  • Thymus Neoplasms / complications
  • Thymus Neoplasms / diagnosis
  • Thymus Neoplasms / mortality
  • Thymus Neoplasms / surgery*