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Media Gallery

Anatomy of thymus, with emphasis on blood supply and relation to recurrent laryngeal and phrenic nerves.
Lateral view of thymus. Thymic arteries are derived from adjacent internal mammary arteries; inferior thymic vein empties into innominate vein. Thymus gland's surrounding vascular and neural structures may be invaded during spread of thymoma.
CT scan clearly illustrates mass in right anterolateral mediastinum.

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Table 1. Survival of Thymoma by Stage: Memorial Sloan-Kettering Experience

Stage	5-Year Survival	10-Year Survival
I	90%	80%
II	90%	80%
III	60%	30%
IV	Less than 25%	N/A

Table 2. World Health Organization (WHO) Pathologic Classification and Associated Prognostic Categories

Type	Histologic Description	*Disease-Free Survival at 10 years, %**
A	Medullary thymoma	100
AB	Mixed thymoma	100
B1	Predominantly cortical thymoma	83
B2	Cortical thymoma	83
B3	Well-differentiated thymic carcinoma	35
C	Thymic carcinoma	28
*Series of 100 thymomas resected in Japan between 1973 and 2001 using WHO classification.^[6]

Table 3. Masaoka Staging System of Thymomas and Corresponding Therapy

Stage	Definition	Treatment
I	Encapsulated tumor with no gross or microscopic invasion	Complete surgical excision
II	Macroscopic invasion into the mediastinal fat or pleura or microscopic invasion into the capsule	Complete surgical excision and postoperative radiotherapy to decrease the incidence of local recurrence
III	Invasion of the pericardium, great vessels, or lung	Complete surgical excision and postoperative radiotherapy to decrease the incidence of local recurrence
IVA	Pleural or pericardial metastatic spread	Surgical debulking, radiotherapy, and chemotherapy
IVB	Pleural or pericardial metastatic spread	Surgical debulking, radiotherapy, and chemotherapy

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Author

Kendrix J Evans, MD, MS Resident Physician, Department of General Surgery, University of Utah School of Medicine

Kendrix J Evans, MD, MS is a member of the following medical societies: American College of Surgeons, American Medical Association, American Medical Student Association/Foundation, Association of Military Surgeons of the US, Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Coauthor(s)

Quintessa Miller, MD, FACS Miller Plastic Surgery

Quintessa Miller, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Albert Letch Kline, MD Chief, Academic Affliations, Gulf Coast Veterans Health Care System; Clinical Assistant Professor, Department of Surgery, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine

Albert Letch Kline, MD is a member of the following medical societies: American College of Chest Physicians, American College of Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

John Geibel, MD, MSc, DSc, AGAF Vice Chair and Professor, Department of Surgery, Section of Gastrointestinal Medicine, Professor, Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital; American Gastroenterological Association Fellow; Fellow of the Royal Society of Medicine

John Geibel, MD, MSc, DSc, AGAF is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, Society for Surgery of the Alimentary Tract

Disclosure: Nothing to disclose.

Additional Contributors

Juan B Ochoa, MD Assistant Professor, Department of Surgery, University of Pittsburgh School of Medicine; Medical and Scientific Director, HCN, Nestle Healthcare Nutrition

Disclosure: Nothing to disclose.

Acknowledgements

Michael A Grosso, MD Consulting Staff, Department of Cardiothoracic Surgery, St Francis Hospital

Michael A Grosso, MD is a member of the following medical societies: American College of Surgeons, Society of Thoracic Surgeons, and Society of University Surgeons

Disclosure: Nothing to disclose.

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