Mediastinal tumors
What is it?
These are epithelial tumors that originate from the remnants of the thymus and are therefore located in the anterior mediastinum. From a histological point of view there are 6 histotypes: A, AB, B1, B2, B3, C. Only the rare type A has a benign behavior; the other 5 histotypes have an increasing malignancy, can have a local invasiveness and give distant metastases. Frequent is the association of these tumors with autoimmune diseases such as myasthenia gravis.
Which are the symptoms?
Small thymomas are usually asymptomatic and represent an occasional radiographic finding. As the size of the neoplasm increases, symptoms related to the encumbrance of the tumor mass (respiratory fatigue, cough, pain) appear. In cases of associated myasthenia gravis, the clinical picture may be dominated by the symptoms of this disease, which are muscle weakness and exhaustion.
- Respiratory fatigue
- Coughing
- Pain
- Weakness
- Muscle exhaustion
How is it diagnosed?
The diagnosis of thymoma is based on radiological study. CT and MRI of the chest allow precise definition of the lesion and evaluation of possible invasion of the tumor to adjacent structures. The diagnosis is obtained by agocytobioptic sampling under ultrasound or CT guidance, or by surgical biopsy with minimally invasive procedures (anterior mediastinotomy, videothoracoscopy).
How is it treated?
Surgical therapy represents the most effective treatment of such tumors. The removal of the tumor and the thymic residue is performed with a minimally invasive approach in cases of small tumors and through an opening of the sternum (sternotomy) in the remaining cases. In the invasive forms, treatment protocols are used that involve the combination of surgery with radiotherapy and chemotherapy. Treatment outcomes depend on the stage of disease; overall survival of patients undergoing thymectomy is 75% over 10 years.
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