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Chest Diseases

Thymoma

Thymoma is a tumor originating from the thymus gland, which is located in the front and upper part of the chest cavity, right behind the breastbone (sternum), and plays a role in the development of the immune system.

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ℹWhat is Thymoma?

The primary function of the thymus gland is the maturation of T cells. Thymoma and thymic carcinoma are referred to as Thymic Epithelial Tumors (TETs).

  • Thymoma: Cancer cells look very similar to the normal cells of the thymus gland; they grow slowly and rarely spread outside the thymus.

  • Thymic Carcinoma: It grows faster and is more likely to spread. Approximately one out of every five TET cases is thymic carcinoma.

In the WHO classification, Type A and AB generally follow a favorable course, Type B (B1, B2, B3) is increasingly more aggressive, and Type C is directly classified as thymic carcinoma.

Common Symptoms

Persistent Dry Cough
A stubborn dry cough.
Shortness of Breath
Observed due to the mass pressing on the windpipe (trachea).
Chest Pain
A feeling of dull pain behind the sternum.
Hoarseness
Occurs when the mass presses on the nerves of the vocal cords.
Difficulty Swallowing (Dysphagia)
Develops due to the tumor pressing on the esophagus.
Superior Vena Cava Syndrome
Swelling in the face, neck, upper body, or arms.
Myasthenia Gravis
Occurs in 30-50% of patients. Characterized by muscle weakness, drooping eyelids, double vision, and getting tired quickly.

Diagnosis Methods

Computed Tomography (CT)
The "Gold Standard" in diagnosis. It best shows the size, location, and relationship of the tumor with surrounding tissues.
MRI
Preferred for suspected vascular involvement or tissue characterization.
PET-CT
Shows the biological activity of the tumor and evaluates distant spread.
AChR Antibodies
Requested when thymoma is suspected, even if there are no symptoms of myasthenia gravis.
Biopsy
If the mass appears resectable, direct surgery is preferred (due to seeding risk). Needle biopsy is performed if neoadjuvant chemotherapy is planned for large tumors.

Treatments

Surgery
The most important treatment method. R0 Resection (complete removal of the tumor leaving no tissue behind) is the criterion for success.
Radiotherapy
Applied as adjuvant therapy after surgery or to destroy remaining cancer cells.
Chemotherapy
Used for Neoadjuvant (to shrink the tumor) purposes or in advanced stages.
Hormone Therapy
Octreotide may be used in tumors with somatostatin receptors.
Targeted Therapy
Tyrosine kinase inhibitors (sunitinib, lenvatinib) and mTOR inhibitors (everolimus) may be used in recurrent cases.
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