Thymoma surgery
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Thymoma Microchapters |
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Diagnosis |
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Case Studies |
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Thymoma surgery On the Web |
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American Roentgen Ray Society Images of Thymoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2]
Overview
Surgery is the only curative treatment. Surgical biopsy should be avoided if a thymoma is highly suspecte based on clinical and radiological evaluation.The goal of surgery is complete resection of the tumor by total thymectomy and complete resection of the contiguous and noncontiguous disease.
Surgery
Complte resection may require resection of the adjacent structures including pleura, lungs, pericardium, phrenic nerves and sometimes major vascular structures. Pleural surfaces should be examined for fear of metastasis. There is no long term data to support minimally invasive procedures.[1] A full median sternotomy is the standard open approach. The mediastinum must be explored for cervical thymus extensions and laterally down to the phrenic nerves.
| Stage I | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| **Diagnosis of thymoma | Resectable | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Chemotherapy single agent e.g. IFo or combination e.g. ADOC or CAPP | Surgical resection | Incomplete resection | Radio/chemo therapy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Stage II/III/IV | Unresectable | Radiotherapy | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| **Relapse | |||||||||||||||||||||||||||||||||||||||
| Resectable | Unresectable | ||||||||||||||||||||||||||||||||||||||
| Radiotherapy | Corticosteroids/octreotide | ||||||||||||||||||||||||||||||||||||||
| Surgical resection | |||||||||||||||||||||||||||||||||||||||
| Incomplete resection | |||||||||||||||||||||||||||||||||||||||
| Radiotherapy | |||||||||||||||||||||||||||||||||||||||
Surgery is the mainstay of treatment.If the tumor is apparently invasive and large, preoperative (neoadjuvant) chemotherapy and/or radiotherapy may be used to decrease the size and improve resectability, before surgery is attempted. When the tumor is an early stage (Masaoka I through IIB), 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).[3]
References
- ↑ "https://www.nccn.org/store/login/login.aspx?ReturnURL=http://www.nccn.org/professionals/physician_gls/pdf/thymic.pdf" (PDF). External link in
|title=(help) - ↑ "http://www.cancertreatmentreviews.com/article/S0305-7372(11)00249-0/abstract". External link in
|title=(help) - ↑ Thomas CR, Wright CD, Loehrer PJ (1999). "Thymoma: state of the art". Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 17 (7): 2280–9. PMID 10561285. Text "accessdate" ignored (help); Unknown parameter
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