A single institutional experience of surgically resected Thymomas– Clinicopathological analysis

  • Thapa B, Barnett S, Gooi J, Seevanayagam S, Knight S.

Abstract

Introduction: Epithelial thymic tumours (ett), which comprise the majority of thymomas, are neoplasias developed from the epithelial cells of the thymus and constitute around 30% of anterior mediastinal masses in adults. This study aims at analyzing the clinicopathological aspects of thymomas encountered in a single thoracic surgical unit.Material and methods: a retrospective analysis of prospectively maintained data of thymoma diagnosed and treated in the thoracic surgery unit of the austin hospital from 1992-2010.Results: forty –eight patients were operated for thymomas in the mentioned duration. The ages ranged from 22-86 years with a mean age of 54.47 With a peak in the 51-70 years age group. Twelve of the 48 patients (25%) had presented with myaesthenia gravis of the 29 cases which were diagnosed after 1999 (post introduction of new who classi" cation), there were three cases of type a, three of ab, eight of b1, six of b2, ten of b3. There were also two cases of mixed b1+ b2 and six of mixed b2+ b3 histologies. Sixty –four percentage of the tumours were masaoka Stage II , 21% of stage I, 10.5% of stage III and 3.5% of stage IV a. Surgery was used as the primary modality of treatment, six of these patients underwent V.A.T.S. thymectomy. There was no peri-operative mortality. Radiotherapy in the adjuvant setting was used in the 78% patients with Masaoka Stges II-IV.Conclusion: Thymomas are relatively uncommon. Their varied histology and clinical behavior have made development of de" nitive treatment algorithms dif" cult. When possible resection offers the best treatment. Minimally invasive thoracoscopic excision seems especially attractive in the small tumours. Keywords: Thymoma, Myaesthenia Gravis , V.A.T.S.

Author Biography

Thapa B, Barnett S, Gooi J, Seevanayagam S, Knight S.
Department of Thoracic Surgery, Austin Hospital, Heidelberg, Victoria, Australia

References

1.Blumberg D, Port JL, Weksler B, Delgado R, Rosai J, Bains MS. et al. Thymoma: A multivariate analysis of factors predicting survival. Ann thorac Surg 1995;60; 908-14.
2. Latteo R. Thymoma and other tumours of the Thymus: an analysis of 107 cases. Cancer 1962;15:1224- 60.
3. Suster S. Diagnosis of Thymoma. J Clin Pathol.2006;59:1238-44.
4. Masaoka A, Monden Y, Nakahara K, Tanioka T. Follow-up study of Thymomas with special reference to their clinical stages. Cancer 1981;48:2485-92.
5. Lardinios D,Rechsteiner R, Lang RH. Prognostic relevance of Masaoka and Muller Hermelink classi" cation in patients with thymic tumours. Ann Thorac Surg. 2004;24:4113-19.
6. Sperling B,Marshall J,Kennedy R, Pahwa P, Chibbar R. Thymoma: a review of the clinical and pathological " ndings in 65 cases. Can J Surg.2003;46:37-42.
7. Cirino LMI, de Campos JRM, Fernandez A, Samano MN, Fernandez PP, Filomeno LTB, Jatene FB. Diagnosis and treatment of mediastinal tumours by thoracoscopy. Chest 2000;117:1787-92.
8. Cheng YJ, Kao EL, Chou SH. Videothoracoscopic resection of stage II thymoma. Prospective comparison of results between thoracoscopy and open methods. Chest. 2005;128:3010-12.
9. Suster S, Moran CA. Thymoma, atypical thymoma and thymic carcinoma. Am J Clin Pathol 1999;111:826-33.
10. Wick WR, Weiland WH, Scheithauer BW, Bernatz PE. Primary Thymic Carcinomas. Am J of Surg Pathol. 1982;6:451-70.
11. Dawson A, Ibrahim NB, Gibbs AR, Observer variation in the histopathological classi" cation of thymoma: correlation with prognosis. J Clin Path.1994;47:519- 23.
12. Gawrychowski J, Rokcki M, Gabriel A, Lackowska B, Czyzewski D. Thymoma-the usefulness of some prognostic factors for the diagnosis and surgical treatment. Eur J Surg Oncol. 2000;26:203-8
13. Prokakis P, Koletsis E, Apostokalis E,Zolota V, Chroni E, Baltayiannis N et al. Modi" ed Maximal Thymectomy for Thymic Epithelial Tumours :Predictors of Survival and Neurological outcome in Patients with Thymomatous Myasthenia Gravis. World J Surg. 2009; 33:1650-58.
14. Pescarmona E, Rendina EA, Venut F, D’Arcangelo E, Pagani M, Ricci C, et al. Analysis of prognostic factors and clinicopathologic staging of Thymoma. Ann Thorac Surg. 1990;50:534-8.
15. Graeber GM, Tamim W. Current status of the diagnosis and treatment of Thymoma. Semin Thorac Cardiovasc Surg. 2000;12(4): 268-77.
16. Sugarbaker DJ. Thoracoscopy in the management of anterior mediastinal masses. Ann Thorac Surg.1993;56:653-56.
17. Roviaro G, Varoli F, Nucca O, Vergani C, Maciocco M.videothoracoscopic approach to primary mediastinal pathology. Chest. 2000;1179-83.
Published
2015-03-13
How to Cite
SEEVANAYAGAM S, KNIGHT S., Thapa B, Barnett S, Gooi J,. A single institutional experience of surgically resected Thymomas– Clinicopathological analysis. J Soc Surg Nep, [S.l.], v. 16, n. 1, mar. 2015. ISSN 2392-4772. Available at: <http://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=2>. Date accessed: 24 feb. 2021.
Section
Original Article