Abstract

BackgroundThymic tumors are unusual neoplasms, representing 0.2 to 1.5% of tumors in humans, but correspond to 20% of mediastinal tumors and 50% of those that occur in the anterior mediastinum. They tend to appear around the fourth and fifth decades of life without gender predilection. Up to 30% of patients are asymptomatic, therefore many are incidentally diagnosed. Radical thymectomy is the treatment of choice with high survival rates when detected in the early stages.MethodsThis was a retrospective descriptive study, including 18 adult patients’ diagnosis of thymic neoplasm, who were managed with surgical resection from 2011 to 2019. Information about demographics, clinical characteristics, imaging findings, surgical and medical management, plus histological findings was obtained and reported.Results18 patients with thymic tumors were included, of which specific histologic studies reveled thymomas, carcinomas, neuroendocrine tumors, thymolipoma and thymic cyst. Mean age was 52.7 years, with a predominance of male population. The main symptom was dyspnea, followed by cough and chest pain. Paraneoplastic syndromes such as myasthenia gravis, aplastic anemia and Cushing syndrome were reported. 89% of cases were treated by radical thymectomy alone, while only 2 cases required chemotherapy and radiotherapy. There were no surgical complications. Mean hospital stay length was 11. 9 days, with only 1 mortality during hospital admission. 5-year survival rate was 81%.ConclusionsThe treatment of choice is radical thymectomy, which has been shown to positively impact patient mortality. Early detection is key to improve patient outcomes.

Highlights

  • Thymic tumors are unusual neoplasms, representing 0.2 to 1.5% of tumors in humans, but correspond to 20% of mediastinal tumors and 50% of those that occur in the anterior mediastinum

  • The objective of this study is to describe the demographic, clinical, radiological and histological characteristics of 18 patients with thymic tumors, who were taken to surgical tumor resection at Fundación Valle del Lili, a high complexity institution in Cali-Colombia, between 2011 and 2019

  • Demographic and clinical characteristics 18 patients with diagnosis of thymic tumor were treated at our institution between 2011 and 2019; 11 male (61%) and 7 females (39%), with a mean age of 52.7 years (±16.6). 3 patients were asymptomatic (16.6%)

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Summary

Introduction

Thymic tumors are unusual neoplasms, representing 0.2 to 1.5% of tumors in humans, but correspond to 20% of mediastinal tumors and 50% of those that occur in the anterior mediastinum They tend to appear around the fourth and fifth decades of life without gender predilection. Thymus tumors include neoplasms that arise from or differ from thymic cell constituents, comprising thymic epithelial tumors (thymomas, thymic carcinomas, neuroendocrine tumors), germ cell, lymphoid and hematopoietic, and mesenchymal tumors [1] They are unusual neoplasms, representing 0.2 to 1.5% of tumors in humans, with an incidence of 0.1 to 0.5 cases per 100,000 individuals per year in the United States [2]. 25 to 30% of patients are asymptomatic, and are incidentally diagnosed, 50% being revealed by chest computed tomography (CT) [5]. 40% of patients present with local symptoms triggered by mass effect (mainly chest pain, cough, snoring and dyspnea), 30% report constitutional symptoms (weight loss, fever and night sweats), and 30– 50% present with paraneoplastic syndromes [4, 6]

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