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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''.
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| {{Infobox_Disease | | {{Infobox_Disease |
| | Name = {{PAGENAME}} | | | Name = {{PAGENAME}} |
| | Image = Thymoma gross.jpg | | | Image = Thymoma gross.jpg |
| | Caption = Thymoma: A bottle-shaped tumor is encapsulated and shows a bulging, rather homogeneous, faintly lobulated ivory-colored cut surface. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small> | | | Caption = Thymoma: A bottle-shaped tumor is encapsulated and shows a bulging, rather homogeneous, faintly lobulated ivory-colored cut surface. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small> |
| | DiseasesDB = 13067
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| | ICD10 = C37.9, D60
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| | ICD9 = {{ICD9|164.0}}, {{ICD9|212.6}}
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| | ICDO = 8580
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| | OMIM =
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| | MedlinePlus = 001086
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| | MeshID = D013945
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| }} | | }} |
| {{Thymoma}} | | {{Thymoma}} |
| {{CMG}} | | {{Seealso|Thymic carcinoma}} |
| {{MJM}}
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| __NOTOC__
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| {{Editor Join}} | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''. |
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| ==Overview==
| | {{CMG}}; {{MJM}}; {{AM}} {{Sab}} |
| In [[medicine]] ([[oncology]]), '''thymoma''' is a [[tumor]] originating from the [[thymus]]. It consists of any type of thymic [[epithelial cell]] as well as [[lymphocyte]]s that are usually abundant and probably not [[neoplastic]]. Thymoma usually is [[benign]], and frequently encapsulated; when occasionally [[malignant]], then it is [[invasive]]: [[metastasis]] is extremely rare. Malignant [[lymphomas]] that involve the thymus, e.g., [[lymphosarcoma]], [[Hodgkin's disease]] (termed "granulomatous thymoma" in the past), should not be regarded as thymoma. Thymoma is a [[rare disease]], best known for its enigmatic association with the neuromuscular disorder [[myasthenia gravis]].<ref name=Thomas1999>{{cite journal |author=Thomas CR, Wright CD, Loehrer PJ |title=Thymoma: state of the art |journal=J. Clin. Oncol. |volume=17 |issue=7 |pages=2280–9 |year=1999 |pmid=10561285 |doi=}}</ref>
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| | {{SK}} Thymoma; Invasive thymoma; Thymic epithelial tumor |
| ==[[Thymoma overview|Overview]]== | | ==[[Thymoma overview|Overview]]== |
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| ==[[Thymoma pathophysiology|Pathophysiology]]== | | ==[[Thymoma pathophysiology|Pathophysiology]]== |
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| ==[[Thymoma epidemiology and demographics|Epidemiology & Demographics]]==
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| ==[[Thymoma risk factors|Risk Factors]]==
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| ==[[Thymoma screening|Screening]]==
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| ==[[Thymoma causes|Causes]]== | | ==[[Thymoma causes|Causes]]== |
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| ==[[Thymoma differential diagnosis|Differentiating Thymoma]]== | | ==[[Thymoma differential diagnosis|Differentiating Thymoma from other Diseases]]== |
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| ==[[Thymoma natural history|Complications & Prognosis]]== | | ==[[Thymoma epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Diagnosis== | | ==[[Thymoma risk factors|Risk Factors]]== |
| [[Thymoma history and symptoms|History and Symptoms]] | [[Thymoma physical examination|Physical Examination]] | [[Thymoma staging|Staging]] | [[Thymoma laboratory tests|Laboratory tests]] | [[Thymoma electrocardiogram|Electrocardiogram]] | [[Thymoma x ray|X Rays]] | [[Thymoma CT|CT]] | [[Thymoma MRI|MRI]] [[Thymoma echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Thymoma other imaging findings|Other images]] | [[Thymoma other diagnostic studies|Alternative diagnostics]] | |
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| ==Treatment== | | ==[[Thymoma screening|Screening]]== |
| [[Thymoma medical therapy|Medical therapy]] | [[Thymoma surgery|Surgical options]] | [[Thymoma primary prevention|Primary prevention]] | [[Thymoma secondary prevention|Secondary prevention]] | [[Thymoma cost-effectiveness of therapy|Financial costs]] | [[Thymoma future or investigational therapies|Future therapies]]
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| ==Signs and symptoms== | |
| A third of all people with a thymoma have symptoms due to compression of the surrounding organs by an expansive mass. This may take the form of [[vena cava superior syndrome]] (compression of the [[vena cava superior|upper caval vein]]), [[dysphagia]] (difficulty swallowing), [[cough]] or [[chest pain]].<ref name=Thomas1999/>
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| A third have a thymoma detected because they have an associated [[autoimmune disorder]]. The most common condition in this group is [[myasthenia gravis]] (of which 25-50% are associated with a thymoma); patients with myasthenia are routinely screened for thymoma. Other associated autoimmune conditions are [[pure red cell aplasia]] and Good's syndrome (thymoma with [[combined immunodeficiency]] and hypoimmunoglobulinemia G). Rare associations that have been reported are: [[acute pericarditis]], [[Addison's disease]], [[agranulocytosis]], [[alopecia areata]], [[ulcerative colitis]], [[Cushing's disease]], [[hemolytic anemia]], limbic encephalopathy, [[myocarditis]], [[nephrotic syndrome]], [[panhypopituitarism]], [[pernicious anemia]], [[polymyositis]], [[rheumatoid arthritis]], [[sarcoidosis]], [[scleroderma]], sensorimotor radiculopathy, ''[[stiff person syndrome]]'', [[systemic lupus erythematosus]] and [[thyroiditis]].<ref name=Thomas1999/>
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| A third to half of all people with a thymoma have no symptoms at all, and the mass is identified on a [[chest X-ray]] performed for an unrelated problem.<ref name=Thomas1999/>
| | ==[[Thymoma natural history|Natural History, Complications and Prognosis]]== |
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| ==Diagnosis== | | ==Diagnosis== |
| When a thymic mass is identified, the made is achieved with [[histology]] (obtaining a tissue sample of the mass). When a thymoma is suspected, a [[Computed axial tomography|CT/CAT scan]] is generally performed to estimate the size of the tumor, and can be [[biopsy|biopsied]] with a CT-guided needle. There is a small risk of [[pneumomediastinum]], [[mediastinitis]] and the risk of damaging the [[heart]] or large blood vessels. The final diagnosis is made by removing the thymus. [[Anatomical pathology|Pathological]] investigation of the specimen will reveal if the tumor was benign or malignant, although the initial biopsy is usually indicative.<ref name=Thomas1999/>
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| The tumor is generally located inside the thymus, and can be calcified. Increased vascular enhancement can be indicative of malignancy, as can be pleural deposits.<ref name=Thomas1999/>
| | [[Thymoma diagnostic study of choice|Diagnostic Study of Choice]] | [[Thymoma history and symptoms|History and Symptoms ]] | [[ Thymoma physical examination|Physical Examination]] | [[ Thymoma staging|Staging]] | [[Thymoma laboratory tests|Laboratory Findings]] | [[Thymoma electrocardiogram|Electrocardiogram]] | [[Thymoma chest x ray|Chest X Ray]] | [[Thymoma CT|CT]] | [[Thymoma MRI|MRI]] | [[Thymoma echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Thymoma other imaging findings|Other Imaging Findings]] | [[Thymoma other diagnostic studies|Other Diagnostic Studies]] |
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| If the suspicion is high, some [[blood test]]s are often performed to look for associated problems or possible spread. These include: [[full blood count]], [[protein electrophoresis]], [[antibodies]] to the [[acetylcholine receptor]] (indicative of myasthenia), [[electrolyte]]s, [[liver enzyme]]s and [[renal function]].<ref name=Thomas1999/>
| | ==[[Thymoma treatment|Treatment]]== |
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| <div align="center">
| | [[Thymoma medical therapy|Medical Therapy]] | [[Thymoma surgery |Surgery]] | [[Thymoma radiotherapy |Radiotherapy]] | [[Thymoma Primary Prevention|Primary Prevention]] | [[Thymoma Secondary Prevention|Secondary Prevention]] | [[Thymoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Thymoma future or investigational therapies|Future or Investigational Therapies]] |
| <gallery heights="175" widths="175">
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| Image:Thymoma-001.jpg|CT shows [[Thymoma]] <small>(Image courtesy of RadsWiki and copylefted)</small>
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| </gallery>
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| </div>
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| ==Pathophysiology== | | ==Case Studies== |
| Thymoma originates from the [[epithelium|epithelial]] cell population in the thymus. Many subtypes are recognized, some of which have a better- or worse-than-general prognosis.<ref name=Thomas1999/>
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| ==Treatment==
| | [[Thymoma case study one|Case #1]] |
| Surgery is the mainstay of treatment. If the tumor was benign and was removed completely, no further therapy is necessary. Removal of the thymus in adults does not appear to induce a severe [[immune deficiency]]. In children, however, added care and scrupulous vaccination are necessary to protect from infections. Malignant tumors may need additional treatment with [[radiotherapy]], or sometimes with chemotherapy ([[cyclophosphamide]], [[doxorubicin]] and [[cisplatin]]).<ref name=Thomas1999/>
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| ==Prognosis== | | ==Related Chapters== |
| Thymomas associated with autoimmune disorders usually are benign. Malignant thymomas can [[metastasis|metastasize]], generally to [[pleura]], [[kidney]], [[bone]], [[liver]] or [[brain]].<ref name=Thomas1999/>
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| ==Epidemiology==
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| Men and women are equally affected. The typical age at diagnosis is 30-40, although cases have been described in every age group.<ref name=Thomas1999/>
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| ==See also==
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| *[[Mediastinal tumor]] | | *[[Mediastinal tumor]] |
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| ==References==
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| <references/>
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| ==External links==
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| * [http://www.thymoma.org A large resource about thymoma]
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| {{Epithelial neoplasms}} | | {{Epithelial neoplasms}} |
| {{SIB}}
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| [[Category:Oncology]] | | [[Category:Oncology]] |
| [[Category:Types of cancer]] | | [[Category:Types of cancer]] |
| [[Category:Rare diseases]] | | [[Category:Rare diseases]] |
| | | [[Category:Disease]] |
| | | [[Category:Up-To-Date]] |
| [[de:Thymom]] | | [[Category:Oncology]] |
| [[no:Thymom]] | | [[Category:Medicine]] |
| [[ru:Тимома]] | | [[Category:Hematology]] |
| [[et:Tümoom]] | | [[Category:Immunology]] |
| | | [[Category:Surgery]] |
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