Skip to main content

Advertisement

Log in

Advances in thymic carcinoma diagnosis and treatment: a review of literature

  • Review Article
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Thymomas account for up to 50 % of anterior mediastinal neoplasms with an incidence of 0.13 per 100,000 person-years in the USA. Thymic carcinoma is a rare malignancy of the thymus gland distinguished from thymomas as it has a more invasive and metastasizing potential conferring poor prognosis. Due to the rarity of thymic carcinoma and the great variety of its histological subtypes, there is no solid evidence on optimal staging, imaging and treatment guidelines. Herein, we systematically review the literature on current clinical practice with regard to diagnostic evaluation, histopathological assessment, management and treatment of squamous thymic carcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Engels EA. Epidemiology of thymoma and associated malignancies. J Thorac Oncol. 2010;5(10 Suppl 4):S260–5.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Venuta F, et al. Thymoma and thymic carcinoma. Eur J Cardiothorac Surg. 2010;37(1):13–25.

    Article  PubMed  Google Scholar 

  3. Chen G, et al. New WHO histologic classification predicts prognosis of thymic epithelial tumors: a clinicopathologic study of 200 thymoma cases from China. Cancer. 2002;95(2):420–9.

    Article  PubMed  Google Scholar 

  4. Wright CD, et al. Predictors of recurrence in thymic tumors: importance of invasion, World Health Organization histology, and size. J Thorac Cardiovasc Surg. 2005;130(5):1413–21.

    Article  PubMed  Google Scholar 

  5. Marx A, et al. Thymic carcinoma: is it a separate entity? From molecular to clinical evidence. Thorac Surg Clin 2011;21(1):25–31, v–vi.

  6. Eng TY, et al. Thymic carcinoma: state of the art review. Int J Radiat Oncol Biol Phys. 2004;59(3):654–64.

    Article  PubMed  Google Scholar 

  7. Moran CA, Suster S. Thymic carcinoma: current concepts and histologic features. Hematol Oncol Clin North Am. 2008;22(3):393–407.

    Article  PubMed  Google Scholar 

  8. Marchevsky AM, McKenna RJ Jr, Gupta R. Thymic epithelial neoplasms: a review of current concepts using an evidence-based pathology approach. Hematol Oncol Clin North Am. 2008;22(3):543–62.

    Article  PubMed  Google Scholar 

  9. Thymomas and Thymic Carcinomas: NCCN Guidelines Version 1.2014.

  10. Thomas CR, Wright CD, Loehrer PJ. Thymoma: state of the art. J Clin Oncol. 1999;17(7):2280–9.

    CAS  PubMed  Google Scholar 

  11. Rosado-de-Christenson ML, Strollo DC, Marom EM. Imaging of thymic epithelial neoplasms. Hematol Oncol Clin North Am. 2008;22(3):409–31.

    Article  PubMed  Google Scholar 

  12. Inoue A, et al. MR imaging of thymic epithelial tumors: correlation with World Health Organization classification. Radiat Med. 2006;24(3):171–81.

    Article  PubMed  Google Scholar 

  13. Sharma P, et al. Evaluation of thymic tumors with 18F-FDG PET–CT: a pictorial review. Acta Radiol. 2013;54(1):14–21.

    Article  PubMed  Google Scholar 

  14. Kitami A, et al. Chemotherapy of thymic carcinoma: analysis of seven cases and review of the literature. Jpn J Clin Oncol. 2001;31(12):601–4.

    Article  CAS  PubMed  Google Scholar 

  15. Wakely PE Jr. Fine needle aspiration in the diagnosis of thymic epithelial neoplasms. Hematol Oncol Clin North Am. 2008;22(3):433–42.

    Article  PubMed  Google Scholar 

  16. Kuo TT, Chan JK. Thymic carcinoma arising in thymoma is associated with alterations in immunohistochemical profile. Am J Surg Pathol. 1998;22(12):1474–81.

    Article  CAS  PubMed  Google Scholar 

  17. Kondo K, et al. WHO histologic classification is a prognostic indicator in thymoma. Ann Thorac Surg. 2004;77(4):1183–8.

    Article  PubMed  Google Scholar 

  18. Wright CD. Management of thymomas. Crit Rev Oncol Hematol. 2008;65(2):109–20.

    Article  PubMed  Google Scholar 

  19. Kojika M, et al. Immunohistochemical differential diagnosis between thymic carcinoma and type B3 thymoma: diagnostic utility of hypoxic marker, GLUT-1, in thymic epithelial neoplasms. Mod Pathol. 2009;22(10):1341–50.

    Article  CAS  PubMed  Google Scholar 

  20. Schirosi L, et al. Activating c-KIT mutations in a subset of thymic carcinoma and response to different c-KIT inhibitors. Ann Oncol. 2012;23(9):2409–14.

    Article  CAS  PubMed  Google Scholar 

  21. Hino N, et al. High frequency of p53 protein expression in thymic carcinoma but not in thymoma. Br J Cancer. 1997;76(10):1361–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Mimae T, et al. Protein expression and gene copy number changes of receptor tyrosine kinase in thymomas and thymic carcinomas. Ann Oncol. 2012;23(12):3129–37.

    Article  CAS  PubMed  Google Scholar 

  23. Kelly RJ, et al. Thymic malignancies: from clinical management to targeted therapies. J Clin Oncol. 2011;29(36):4820–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Masaoka A, et al. Follow-up study of thymomas with special reference to their clinical stages. Cancer. 1981;48(11):2485–92.

    Article  CAS  PubMed  Google Scholar 

  25. Giaccone G. Treatment of thymoma and thymic carcinoma. Ann Oncol. 2000;11(Suppl 3):245–6.

    Article  PubMed  Google Scholar 

  26. Kondo K, Monden Y. Lymphogenous and hematogenous metastasis of thymic epithelial tumors. Ann Thorac Surg. 2003;76(6):1859–64 discussion 1864–5.

    Article  PubMed  Google Scholar 

  27. Okereke IC, et al. Thymic carcinoma: outcomes after surgical resection. Ann Thorac Surg. 2012;93(5):1668–72 discussion 1672–3.

    Article  PubMed  Google Scholar 

  28. Strobel P, et al. Tumor recurrence and survival in patients treated for thymomas and thymic squamous cell carcinomas: a retrospective analysis. J Clin Oncol. 2004;22(8):1501–9.

    Article  PubMed  Google Scholar 

  29. Suster S, Rosai J. Thymic carcinoma. A clinicopathologic study of 60 cases. Cancer. 1991;67(4):1025–32.

    Article  CAS  PubMed  Google Scholar 

  30. Kaiser LR. Surgical treatment of thymic epithelial neoplasms. Hematol Oncol Clin North Am. 2008;22(3):475–88.

    Article  PubMed  Google Scholar 

  31. Okumura M, et al. Outcome of surgical treatment for recurrent thymic epithelial tumors with reference to world health organization histologic classification system. J Surg Oncol. 2007;95(1):40–4.

    Article  PubMed  Google Scholar 

  32. Fuller CD, Housman DM, Thomas CR. Radiotherapy for thymoma and thymic carcinoma. Hematol Oncol Clin North Am. 2008;22(3):489–507.

    Article  PubMed  Google Scholar 

  33. Fuller CD, et al. Radiotherapy for thymic neoplasms. J Thorac Oncol. 2010;5(10 Suppl 4):S327–35.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Myojin M, et al. Stage III thymoma: pattern of failure after surgery and postoperative radiotherapy and its implication for future study. Int J Radiat Oncol Biol Phys. 2000;46(4):927–33.

    Article  CAS  PubMed  Google Scholar 

  35. Ogawa K, et al. Postoperative radiotherapy for patients with completely resected thymoma: a multi-institutional, retrospective review of 103 patients. Cancer. 2002;94(5):1405–13.

    Article  PubMed  Google Scholar 

  36. Loehrer PJ Sr, et al. Cisplatin, doxorubicin, and cyclophosphamide plus thoracic radiation therapy for limited-stage unresectable thymoma: an intergroup trial. J Clin Oncol. 1997;15(9):3093–9.

    CAS  PubMed  Google Scholar 

  37. Fornasiero A, et al. Chemotherapy for invasive thymoma. A 13-year experience. Cancer. 1991;68(1):30–3.

    Article  CAS  PubMed  Google Scholar 

  38. Loehrer PJ Sr, et al. Cisplatin plus doxorubicin plus cyclophosphamide in metastatic or recurrent thymoma: final results of an intergroup trial. The Eastern Cooperative Oncology Group, Southwest Oncology Group, and Southeastern Cancer Study Group. J Clin Oncol. 1994;12(6):1164–8.

    PubMed  Google Scholar 

  39. Giaccone G, et al. Cisplatin and etoposide combination chemotherapy for locally advanced or metastatic thymoma. A phase II study of the European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group. J Clin Oncol. 1996;14(3):814–20.

    CAS  PubMed  Google Scholar 

  40. Loehrer PJ Sr, et al. Combined etoposide, ifosfamide, and cisplatin in the treatment of patients with advanced thymoma and thymic carcinoma: an intergroup trial. Cancer. 2001;91(11):2010–5.

    Article  CAS  PubMed  Google Scholar 

  41. Koizumi T, et al. Chemotherapy for advanced thymic carcinoma: clinical response to cisplatin, doxorubicin, vincristine, and cyclophosphamide (ADOC chemotherapy). Am J Clin Oncol. 2002;25(3):266–8.

    Article  PubMed  Google Scholar 

  42. Kim ES, et al. Phase II study of a multidisciplinary approach with induction chemotherapy, followed by surgical resection, radiation therapy, and consolidation chemotherapy for unresectable malignant thymomas: final report. Lung Cancer. 2004;44(3):369–79.

    Article  PubMed  Google Scholar 

  43. Lucchi M, et al. The multimodality treatment of thymic carcinoma. Eur J Cardiothorac Surg. 2001;19(5):566–9.

    Article  CAS  PubMed  Google Scholar 

  44. Lemma GL, et al. Phase II study of carboplatin and paclitaxel in advanced thymoma and thymic carcinoma. J Clin Oncol. 2011;29(15):2060–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  45. Sakai M, et al. Early-stage thymic carcinoma: is adjuvant therapy required? J Thorac Dis. 2013;5(2):161–4.

    PubMed Central  PubMed  Google Scholar 

  46. Loehrer PJ, et al. Octreotide alone or with prednisone in patients with advanced thymoma and thymic carcinoma: an Eastern Cooperative Oncology Group phase II trial. J Clin Oncol. 2004;22(2):293–9.

    Article  CAS  PubMed  Google Scholar 

  47. Okuma Y, et al. S-1 is an active anticancer agent for advanced thymic carcinoma. Lung Cancer. 2010;70(3):357–63.

    Article  PubMed  Google Scholar 

  48. Palmieri G, et al. Preliminary results of phase II study of capecitabine and gemcitabine (CAP–GEM) in patients with metastatic pretreated thymic epithelial tumors (TETs). Ann Oncol. 2010;21(6):1168–72.

    Article  CAS  PubMed  Google Scholar 

  49. Strobel P, et al. Sunitinib in metastatic thymic carcinomas: laboratory findings and initial clinical experience. Br J Cancer. 2010;103(2):196–200.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  50. Rajan A, Giaccone G. Targeted therapy for advanced thymic tumors. J Thorac Oncol. 2010;5(10 Suppl 4):S361–4.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have declared no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Syrios.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Syrios, J., Diamantis, N., Fergadis, E. et al. Advances in thymic carcinoma diagnosis and treatment: a review of literature. Med Oncol 31, 44 (2014). https://doi.org/10.1007/s12032-014-0044-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-014-0044-2

Keywords

Navigation