Pediatric Thymoma Follow-up

Updated: Oct 14, 2021
  • Author: Richard A Bickel, MD; Chief Editor: Harumi Jyonouchi, MD  more...
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Follow-up

Complications

Complications may include the following:

  • Structural problems, such as compression syndromes that involve the bronchi or lungs or superior vena cava syndrome (SVCS), can occur from local spread of benign thymoma, from thymic cysts, or from thymic carcinoma. Presenting symptoms may include chest pain, SVCS, dyspnea, dysphagia, and cough.

  • Areas of benign thymoma can become highly vascular or necrotic and lead to bleeding.

  • Clinical manifestations include paraneoplastic syndromes and immunodeficiency.

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Prognosis

Adverse predictive factors include the following: [43, 44]

  • Invasive or metastatic tumor

  • Tracheal or vascular compression

  • Age younger than 30 years

  • Epithelial or mixed histology

  • Tumor size of more than 8 cm [45]

The presence of myasthenia gravis (MG) with thymomas is no longer considered a poor prognostic factor and is actually thought to be a favorable prognostic factor. [46]

Based on WHO classification, the 5-year and 10-year survival rates are as follows: [47, 48]

  • Type A - 100% and 95%, respectively

  • Type AB - 93% and 90%, respectively

  • Type B1 - 89% and 85%, respectively

  • Type B2 - 82% and 71%, respectively

  • Type B3 - 71% and 40%, respectively

  • Type C - 23% (5-year survival rate)

Recurrence of thymoma can occur after resection. A study surgical outcomes after recurrence of thymic epithelial tumors in 67 patients showed an overall survival rate at 10 years of 70% in those undergoing re-resection. [32]

For patients with Masaoka stage IVA thymomas, a study of 18 patients reported survival rates at 3 years (91%), 5 years (78%), and 10 years (65%). [49] These patients underwent multimodality therapy, including surgical resection, preoperative chemotherapy, and even postoperative radiation therapy (in select patients).

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