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Thymoma and Thymic Carcinoma

Thymoma and thymic carcinoma are rare cancers that form when cancer cells develop on the surface of the thymus. The thymus is a small organ in front of and above the heart and underneath the breastbone, which makes white blood cells to help fight infection. Also called thymic epithelial tumors (TETs), they often develop between the lungs in the front of the chest.

Thymomas and thymic carcinomas behave differently.

  • Thymomas appear like normal thymus cells, usually don’t spread outside the thymus, and are slow growing. Thymomas are often linked to autoimmune paraneoplastic diseases, which cause the body's immune system to attack normal cells as well as cancer cells. These include myasthenia gravis, the most common, Good syndrome, and thymoma-associated autoimmune pure red cell aplasia. There is increased risk for developing another type of cancer after a thymoma diagnosis.
  • Thymic carcinomas do not appear like normal thymus cells, have a greater tendency to spread outside the thymus, and are faster growing. Thymic carcinomas are more difficult to treat and often recur.

Statistics

  • There are approximately 400 diagnoses of thymic cancers in the United States each year.
  • Thymic carcinomas are about 20 percent of all tumors in the thymus.
  • Myasthenia gravis is present in approximately 30-50 percent of people diagnosed with thymic tumors and causes weakness in muscles.

Risk Factors

No risk factors are known for thymomas or thymic carcinoma.

Symptoms

Many patients do not have symptoms at diagnosis. If any of the following symptoms are present, individuals are encouraged to consult a physician.

  • Persistent cough
  • Chest pain
  • Shortness of breath
  • Hoarseness
  • Swollen face, neck, upper body, or arms
  • Muscle weakness
  • Drooping eyelids
  • Double vision
  • Swallowing difficulty
  • Anemia
  • Frequent infections
  • Fatigue
  • Dizziness

Diagnosis and Treatment Options

The diagnostic tests used to determine a thymoma are CT scan of the chest, MRI of the chest, and PET CT scan. This test helps determine if the tumor has spread beyond the thymus or invaded other structures. In some cases, a CT guided biopsy will be used to make the diagnosis.

Treatment for thymoma and thymic carcinoma include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, immunotherapy, and palliative medicine. Surgery is the most common treatment, especially for early-stage cancers that are confined to the thymus. In patients with advanced disease or larger tumors, chemotherapy is sometimes used to before surgery. Some patients will require radiation after surgery, depending on the extent of the tumor. Patients may want to consider a clinical trial. A combination of treatments may provide the most effective treatment.

Texas Oncology’s multidisciplinary program to treat thymomas and thymic tumors includes thoracic surgeons, medical oncologists, and radiation oncologists who work together to treat tumors. Surgeons treat thymomas with minimally invasive techniques (thoracoscopically and robotic) if appropriate. Most patients spend one or two nights in the hospital after surgery. More information is available at Thoracic Surgery.

Sources: American Cancer Society, American Society of Clinical Oncology, and National Cancer Institute

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