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Thymustumoren

Eine klinische Betrachtung

Thymus cancers

A clinical observation

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Zusammenfassung

Hintergrund

Thymustumoren, d. h. Thymome, Thymuskarzinome und -karzinoide, sind mit einer Inzidenz von 0,13/100.000 Einwohnern eine sehr seltene Entität.

Material und Methoden

Anhand einer Literaturrecherche wurden neuere Erkenntnisse zur Epidemiologie, Klassifikationen und verschiedenen Therapieansätzen recherchiert.

Ergebnisse

Die sehr verschiedenen Tumoren können lange klinisch inapparent bleiben, die eigentlichen Thymome (A, AB, B1, B2, B3) können Paraneoplasien verursachen, und Thymuskarzinome wachsen sehr aggressiv. Die chirurgische Resektion wird als der Goldstandard bei den limitierten Tumorstadien I und II angesehen und sollte im lokal fortgeschrittenen Stadium III sowie auch bei bereits pleural metastasierter Situation im Rahmen eines multimodalen Konzepts diskutiert werden. Thymustumoren sind chemotherapiesensibel. Neuere zielgerichtete Therapien haben noch einen geringen Stellenwert und sollten nur in der palliativen Situation nach Versagen mindestens einer Therapielinie eingesetzt werden.

Schlussfolgerung

Insbesondere die neue TNM-Klassifikation (T: Tumor, N: „node“, M: Metastase) der Thymustumoren wird helfen, die Indikationen für die vielfältigen Therapiemöglichkeiten besser zu begründen.

Abstract

Introduction

Thymic tumors including thymomas, thymic carcinomas, and thymic carcinoid tumors are rare tumors with an incidence of 0.13/100,000.

Materials and methods

A literature search was performed to identify recent findings on epidemiology, classification, and various therapeutic approaches.

Results

These tumors with a wide spectrum of histologic and biologic features may be clinically unapparent for a long time or show a very aggressive behavior with local invasion and distant metastases. Surgical resection is the mainstay in stage I and II thymomas, whereas in stage III thymomas and in thymomas with pleural dissemination surgery in context of a multimodal treatment should be discussed. Thymic tumors are chemoreactive. Targeted therapies show poor results and should only be considered in the palliative situation after failure of chemotherapy.

Conclusion

The new TNM (T: tumor, N: node, M: metastasis) classification of thymic tumors will help to identify the best treatment options.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. H. Grosch, H. Hoffmann, C.-A. Weis und M. Thomas geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung Onkologie, Thoraxklinik Heidelberg, Amalienstraße 5, 69126, Heidelberg, Deutschland

    H. Grosch & M. Thomas

  2. Abteilung Chirurgie, Thoraxklinik Heidelberg, Heidelberg, Deutschland

    H. Hoffmann

  3. Abteilung Pathologie, Universitätsklinikum Mannheim, Mannheim, Deutschland

    C.-A. Weis

Authors
  1. H. Grosch
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  2. H. Hoffmann
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  3. C.-A. Weis
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  4. M. Thomas
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Corresponding author

Correspondence to H. Grosch.

Additional information

Redaktion

C. Röcken, Kiel

T. Rüdiger, Karlsruhe

Dieser aktualisierte Beitrag erschien ursprünglich in der Zeitschrift Der Onkologe 2015, 21:859–874. DOI 10.1007/ s00761-015-3025-y. Die Teilnahme an der zertifizierten Fortbildung ist nur einmal möglich.

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Grosch, H., Hoffmann, H., Weis, CA. et al. Thymustumoren. Pathologe 37, 91–106 (2016). https://doi.org/10.1007/s00292-016-0140-5

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  • DOI: https://doi.org/10.1007/s00292-016-0140-5

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