Thymoma Clinical Presentation

Updated: Jul 25, 2022
  • Author: Kendrix J Evans, MD, MS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
  • Print

History and Physical Examination

Of patients with a thymoma, one third to one half are asymptomatic, and one third present with local symptoms related to the tumor's encroachment on surrounding structures. These patients may present with cough, chest pain, superior vena cava (SVC) syndrome, dysphagia, and hoarseness if the recurrent laryngeal nerve is involved. One third of cases are found incidentally on radiographic examinations during a workup for myasthenia gravis (MG).

Although development of a thymoma in childhood is rare, children are more likely than adults to have symptoms. Several explanations for the prevalence of symptoms in children have been proposed, including the following:

  • Children are more likely to have malignancy
  • Lesions are more likely to cause symptoms by compression or invasion in the smaller thoracic cavity of a child
  • The most common location for mediastinal tumors in children is near the trachea, resulting in respiratory symptoms

Four cases of patients who presented with severe chest pain secondary to infarction or hemorrhage of the tumor have been reported. Cases of invasion into the SVC resulting in venous obstruction have also been reported. [4] The clinician should be aware of these rare presentations of a thymoma.