Thymic masses include thymomas, thymic carcinomas and thymic carcinoids.
Thymomas are classified into multiple different histological types, and thymic carcinomas are or categorized as squamous, adenocarcinoma, adenosquamous carcinoma, and carcinoma otherwise specified.
The Masanaka-Koga staging system is used
For the most resectable tumors, complete excision by total thymectomy and complete surgical excision of contiguous with noncontiguous disease is the goal:surgical debulking is discouraged.
Resection of adjacent structures-pericardium, phrenic nerve, pleura, lung, vascular structures may be required for complete resection.
Tissue diagnosis with core needle biopsy is recommended for thymic masses.
Video assisted thoroscopic surgery is safe and patients have similar overall survival when compared with those receiving open thymectomy.
Radiation is used in patients with thymic carcinoma that are unresectable or for patients with incomplete resection with invasive thymoma or thymic carcinoma, or as an adjunct therapy after systemic therapy and surgery for patients with locally advanced disease.
In patients who undergo surgery for thymoma or thymic carcinoma postoperative RT is associated with longer survival.
Systemic therapies are recommended preoperatively for potentially resectable, advanced, metastatic, or recurrent disease with platinum based therapy.