National Cancer Institute®
Last Modified: April 1, 2002
UI - 11757949
AU - D'Avino C; Lucchi M; Ceravolo R; Mussi A; Malandrini A; Annunziata P;
TI - Siciliano G Limbic encephalitis associated with thymic cancer: a case report.
SO - J Neurol 2001 Nov;248(11):1000-2
UI - 11920495
AU - Ogawa K; Uno T; Toita T; Onishi H; Yoshida H; Kakinohana Y; Adachi G;
TI - Itami J; Ito H; Murayama S Postoperative radiotherapy for patients with completely resected thymoma: a multi-institutional, retrospective review of 103 patients.
SO - Cancer 2002 Mar 1;94(5):1405-13
AD - Department of Radiology, University of the Ryukyus School of Medicine, Okinawa, Japan. firstname.lastname@example.org
BACKGROUND: Optimal management of postoperative radiotherapy for patients with completely resected thymoma remains controversial. This study was conducted to assess the efficacy of postoperative mediastinal irradiation in patients with completely resected thymoma. METHODS: The records of 103 patients with completely resected thymoma who received postoperative mediastinal irradiation during the period between 1979 and 1998 were reviewed. The distribution according to Masaoka stage was Stage I in 17 patients, Stage II in 61 patients, and Stage III in 25 patients. Fifty-two patients were treated with involved field (IF) irradiation, and 51 patients were treated with irradiation of the whole mediastinal field with or without boost (WM irradiation). The total radiation dose to the primary tumor bed was 30-61 grays (Gy), with a median dose of 40 Gy. No patients received chemotherapy during the initial treatment. The median follow-up of the 82 living patients was 112 months (range, 24-244 months). RESULTS: The 10-year actuarial overall and disease free survival rates for all patients were 81% and 79%, respectively. The 10-year actuarial overall survival rate was 100% for patients with Stage I disease, 90% for patients with Stage II disease, and 48% for patients with Stage III disease. In the analysis, clinical stage alone had a statistically significant impact on both overall survival and disease free survival (P < 0.0001 for both). Recurrent disease was observed in 17 patients, and the pleura was the most frequent site of first recurrence. Of 12 patients who had pleural recurrences, 11 patients had pleural dissemination remote from the initial tumor site. No recurrence was observed in any of the 17 patients with Stage I disease, and 6 of 61 patients (10%) with Stage II disease and 11 of 25 patients (44%) with Stage III disease experienced recurrences. With regard to intrathoracic recurrences, there were no recurrences within the irradiated field in any of the 103 patients, and no dose response correlation was seen in intrathoracic control (incidence of intrathoracic recurrence: 2 of 19 patients in the group that received < 40 Gy, 6 of 45 patients in the group that received 40 Gy, and 7 of 39 patients in the group that received > 40 Gy). With respect to treatment field, mediastinal recurrences were observed in 4 of 52 patients (8%) who were treated with IF irradiation, whereas 0 of 51 patients who were treated with WM irradiation experienced mediastinal recurrences. Pleural-based recurrences were observed both in patients who were treated with IF irradiation (7 of 52 patients) and in patients who were treated with WM irradiation (5 of 51 patients). According to the degree of pathologic tumor invasion, 0 of 71 patients without pleural invasion had pleural-based recurrences (0 of 17 patients with Stage I disease, 0 of 51 patients with Stage II disease, and 0 of 3 patients with Stage III disease), whereas 12 of 32 patients (38%) with pleural invasion had pleural-based recurrences (4 of 10 patients with Stage II disease and 8 of 22 patients with Stage III disease). CONCLUSIONS: The current results indicated that WM irradiation with a total dose of 40 Gy was effective in preventing mediastinal recurrence for patients with completely resected thymoma. However, in patients with pathologic pleural invasion of the tumor, mediastinal irradiation alone was insufficient to avoid pleural-based recurrence. Copyright 2002 American Cancer Society.
UI - 11934330
AU - Assi AC; Lightman S
TI - Clinicopathologic reports, case reports, and small case series: cytomegalovirus retinitis in patients with Good syndrome.
SO - Arch Ophthalmol 2002 Apr;120(4):510-2
AD - Moorfields Eye Hospital, City Road, London EC1V 2PD, England.
UI - 11884256
AU - Ozer N; Can I; Aytemir K; Atalar E; Erman M; Ovunc K; Aksoyek S;
TI - Demirkazik F; Kes S Malignant thymoma invading the right atrium: a rare echocardiographic finding.
SO - Echocardiography 2002 Jan;19(1):61-2
AD - Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. email@example.com
Malignant thymoma is a rare tumor. We report a case of malignant thymoma with intracaval extension and direct invasion of the right atrium presenting as superior vena cava syndrome.
UI - 11841520
AU - Courville P; Favennec L; Viacroze C; Barrel A; Young P; Abboud P;
TI - Thomine E; Metayer J; Nouvet G Co-existent cutaneous cryptococcosis of the forearm and cutaneous alternariosis of the leg in patient with metastatic thymoma.
SO - J Cutan Pathol 2002 Jan;29(1):55-8
AD - Service d'Anatomie Pathologique, CHRU Charles Nicolle Rouen, France. firstname.lastname@example.org
BACKGROUND: Cryptococcosis and alternariosis are rare opportunistic infections often observed in immunocompromised patients. Because Cryptococcus and Alternaria are ubiquitous fungi found in soil, the presence of fungi in the dermis has to be observed on histological examination to confirm a real cutaneous, invasive, infection. PATIENT: We report the first case of concomitant cutaneous cryptococcosis and cutaneous alternariosis, in an immunocompromised patient treated for a metastatic thymoma. CONCLUSION: This observation underlines the fact that the possible co-existence of several rare infections in immunocompromised patients should take into consideration pathogen identification in order to adapt the therapy to individual patient requirements.
UI - 11413764
AU - Dadmanesh F; Sekihara T; Rosai J
TI - Histologic typing of thymoma according to the new World Health Organization classification.
SO - Chest Surg Clin N Am 2001 May;11(2):407-20
AD - Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
The new WHO classification scheme provides a set of simple and easily reproducible morphologic criteria for an accurate and consistent categorization of thymic epithelial tumors. This scheme should facilitate interobserver reproducibility and lead to a more precise assessment of prognosis when used in combination with the staging system.
UI - 11413765
AU - Port JL; Ginsberg RJ
TI - Surgery for thymoma.
SO - Chest Surg Clin N Am 2001 May;11(2):421-37
AD - Department of Cardiothoracic Surgery, New York-Presbyterian Hospital, New York, New York, USA.
Although thymoma is an uncommon tumor, it represents the most frequently encountered tumor of the anterior mediastinum. These tumors represent an interesting and even peculiar group of lesions by virtue of their association with paraneoplastic disorders, their relatively indolent course, and their predisposition for local recurrence. The initial treatment of choice for patients with thymoma that do not present with unresectable local or diffuse metastatic disease is complete surgical resection. The goals of surgery are complete excision of the lesion with total thymectomy and complete exploration to rule out the presence of noncontiguous disease that may be resectable. Often, complete resection may require the resection of surrounding involved structures including pericardium, pleura, lung, and even major vascular structures. Some authors have suggested VATS or VATS-assisted techniques for small thymomas. Capsular invasion, however, often can be subtle, and the completeness of resection is of prime importance in countless studies. With recurrences appearing up to 5 and even 10 years postoperatively, time will tell if these minimally invasive techniques are comparable with current standard approaches. Multiple studies have failed to determine conclusively the role of induction chemotherapy and adjuvant radiation. Prospective multi-institutional trials are required to elucidate further the role of such therapies in these rare tumors. In the interim, the authors continue to recommend postoperative radiation for all patients undergoing resection with the exception of stage I patients. Some promising reports on response to chemotherapy have led them to develop an induction chemotherapy protocol for patients with clinically advanced disease.
UI - 11413767
AU - Chahinian AP
TI - Chemotherapy of thymomas and thymic carcinomas.
SO - Chest Surg Clin N Am 2001 May;11(2):447-56
AD - Division of Medical Oncology, Department of Medicine, Mount Sinai School of Medicine, New York University, New York, New York, USA.
Thymomas are chemosensitive tumors with overall response rates of about 70% to various chemotherapy regimens. A fraction of patients (up to 25%-30%) will obtain a CR after chemotherapy. These results justify the use of chemotherapy in a multimodality fashion for the treatment of patients with advanced tumors. With radiotherapy added to chemotherapy, if necessary and if technically feasible, inoperable tumors may become resectable, leading to excellent long-term survival. On the other hand, thymic carcinomas are more refractory to chemotherapy, and their prognoses remain poor.
UI - 11413768
AU - Dziuba SJ; Curran WJ Jr
TI - The radiotherapeutic management of invasive thymomas.
SO - Chest Surg Clin N Am 2001 May;11(2):457-66
AD - Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
The role of radiation therapy has been well established for selected patients with thymoma. Among patients with stage I tumors that have undergone a complete surgical excision, there is no indication for postoperative RT. There is also no need for postoperative RT for patients with completely excised stage II tumors when there is no transgression of the tumor through the thymic capsule. If there is transgression of the tumor through the capsule, postoperative RT is recommended even in the presence of complete surgical resection. For totally or partially resected stage III tumors, postoperative RT, to a total dose in excess of 50.4 Gy, is recommended. CT scan-based treatment planning is recommended for all of these indications. The role of preoperative RT is currently less certain. For bulky, unresectable tumors, preoperative chemotherapy and postoperative RT seem to be a promising trimodality approach. There also will be a need for preoperative RT among partial responders.
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