Abstract
Thymomas are the most frequent neoplasms of the anterior mediastinal compartment, accounting for approximately 20% of all mediastinal tumors in adults. They are, however, a rare neoplasm, with an incidence of approximately 0.15 cases in 100,000 habitants per year in the USA [1]. Thymomas are neoplasms of epithelial origin which, despite being considered tumors with an often indolent growth pattern, have a well-documented capability to invade adjacent structures and develop metastases in the pleura as well as, though more rarely, distant metastases. Although several histological classifications have been proposed over the last few years, today there is a wide consensus on the use of the classification proposed by the World Health Organization (WHO) in 1999, as reviewed and confirmed in 2003, which breaks down thymic neoplasms into 6 groups based on the presence of cellular atypias and based on the relationship between epithelial and lymphatic cells (Table 16.1) [2]. By now, a unanimous consensus has been reached on the staging system proposed by Masaoka in 1981 and reviewed in 1994 (Table 16.2) [3], which classifies neoplasms based on the presence or absence of a macroscopic or microscopic invasion of the capsule, of adjacent structures, and the presence of metastases.
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References
Engels EA, Pfeuffer RM (2003) Malignant thymoma in the United States: Demographic patterns in incidence and associations with subsequent malignancies. Int J Cancer 105:546–551
Muller-Hermelink H, Engel P, Harris N et al (2004) Tumors of the thymus. In: Travis W, Brambilla E, Muller-Hermelink (eds) Tumors of the lung, thymus and heart. Pathology and genetics. IARC Press, Lyon
Masaoka A, Yamakawa Y, Niwa H et al (1994) Thymectomy and malignancy. Eur J Cardiothoracic Surg 8:251–253
Detterbeck FC (2006) Clinical value of the WHO classification system of thymoma. Ann Thorac Surg 81(6):2328–2334
Thomas CR, Wright CD, Loehrer PJ (1999) Thymoma: State of the art. J Clin Oncol 17:2280–2289
Ogawa K, Uno T, Toita T et al (2002) Postoperative radiotherapy for patients with completely resected thymoma. Cancer 94:1405–1413
Mangi AA, Wright CD, Allan JS et al (2002) Adjuvant radiation therapy for stage II thymoma. Ann Thorac Surg 74:1033–1037
Venuta F, Rendina EA, Longo F et al (2003) Long-term outcome after multimodality treatment for stage III thymic tumors. Ann Thorac Surg 76:1866–1872
Lucchi M, Ambrogi MC, Duranti L et al (2005) Advanced stage thymomas and thymic carcinomas: Results of multimodality treatments. Ann Thorac Surg 79:1840–1804
Kim ES, Putnam JB, Komaki R et al (2004) Phase II study of multidisciplinary approach with induction chemotherapy followed by surgical resection, radiation therapy and consolidation chemotherapy for unresectable malignant thymomas: Final report. Lung Cancer 44:369–379
Gotte JM, Bilfinger TV (2007) Resection of giant rightsided thymoma using a lateral thoracotomy approach followed by median sternotomy for completion thymectomy. Thoracic Cardiovasc Surg 55(5):336–338
Patterson GA (1992) Thymomas. Semin Thorac Cardiovasc Surg 4:39–44
Port JL, Ginsberg RJ (2001) Surgery for thymoma. Chest Surg Clin North Am 11:421–437
Kornstein MJ, Curran WJ Jr, Turrisi AT 3rd et al (1988) Cortical versus medullary thymoma: A useful morphologic distinction? Hum Pathol 19(11):1335–1339
Shields TW (2005) Thymic tumors. In: Shields TW (ed) General thoracic surgery. Lippincott Williams & Wilkins, Philadelphia, pp 2581–2617
Wright CD (2006) Pleuropneumonectomy for the treatment of Masaoka Stage IVa thymoma. Ann Thorac Surg 82:1234–1239
Wright CD, Wain JV, Wong DR et al (2005) Predictors of recurrence in thymic tumors: Importance of invasion. WHO histology and size. J Thoracic Cardiovasc Surg 130:1413–1421
Kohman LJ (1997) Controversies in the management of malignant thymoma. Chest 112:296S–300S
Liu HC, Chen YJ, Chen CY et al (2006) Debulking surgery for advanced thymoma. Eur J Surg Oncol 32:1000–1005
Loehrer PJ, Chen M, Kim K et al (1979) Cisplatin, doxorubicin and cyclophosphamide plus thoracic radiation therapy for limited-stage unresectable thymomas: An intergroup trial. J Clin Oncol 15:3093–3099
Maggi G, Casadio C, Cavallo A et al (1991) Thymoma: Results of 241 operated cases. Ann Thorac Surg 52(1):175–176
Chalabreisse L, Roy P, Cordier J-F et al (2002) Correlation of the WHO schema for the classification of thymic epithelial neoplasms with prognosis. Am J Surg Pathol 26:1605–1611
Okumura M, Ohta M, Tateyama H et al (2002) The World Health Organization histologic classification system reflects the oncologic behavior of thymoma: A clinical study of 273 patients. Cancer 94:624–632
Nakagawa K, Asamura H, Matsuno Y et al (2003) Thymoma: A clinicopathologic study based on the new World Health Organization classification. J Thorac Cardiovasc Surg 126:1134–1140
Sperling B, Marschall J, Kennedy R et al (2003) Thymoma: A review of the clinical and pathological findings in 65 cases. Can J Surg 46(1):37–42
Ströbel P, Bauer A, Puppe B et al (2004) Tumor recurrence and survival in patients treated for thymomas and thymic squamous cell carcinomas: A retrospective analysis. J Clin Oncol 22:1501–1509
Park MS, Chung KY, Kim KD et al (2004) Prognosis of thymic epithelial tumors according to the new World Health Organization histologic classification. Ann Thorac Surg 78:992–998
Rea F, Marulli G, Girardi R et al (2004) Long-term survival and prognostic factors in thymic epithelial tumors. Eur J Cardiothorac Surg 26:412–418
Kondo K, Yoshizawa K, Tsuyuguchi M et al (2004) WHO histologic classification is a prognostic indicator in thymoma. Ann Thorac Surg 77:1183–1188
Kim DJ, Yang WI, Choi SS et al (2005) Prognostic and clinical relevance of the World Health Organization schema for the classification of thymic epithelial tumors: A clinicopathologic study of 108 patients and literature review. Chest 127:755–761
Rena O, Papalia E, Maggi G et al (2005) World Health Organization histologic classification. An independent prognostic factor in resected thymomas. Lung Cancer 50:59–66
Regnard JF, Magdeleinat P, Dromer C et al (1996) Prognostic factors and long-term results after thymoma resection: A series of 307 patients. J Thorac Cardiovasc Surg 112:376–384
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Morandi, U., Casali, C. (2008). Conventional Techniques: Transthoracic Approach. In: Lavini, C., Moran, C.A., Morandi, U., Schoenhuber, R. (eds) Thymus Gland Pathology. Springer, Milano. https://doi.org/10.1007/978-88-470-0828-1_16
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DOI: https://doi.org/10.1007/978-88-470-0828-1_16
Publisher Name: Springer, Milano
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