Management
Early-stage, discrete thymic tumours should be managed by an experienced thoracic surgeon.
Locally advanced and metastatic thymic malignancies should be managed by a multidisciplinary team comprising medical oncologists, thoracic surgeons, radiation oncologists, pathologists, and radiologists.
Patients with myasthenia gravis should have a formal neurological evaluation.
Note:
- thoracotomy may be considered for diagnosis and removal
- radiotherapy may be indicated for the primary tumour or for any tumour residue - this may be curative in neuroblastoma and thymoma; it may achieve long-term control in malignant teratoma
- combination chemotherapy may be required for neuroblastoma
- treatment with radiotherapy may cause dysphagia and an irritant cough during and immediately after treatment. Occasionally there may be later symptoms of pulmonary fibrosis and pericardial fibrosis.
Reference
- Girard N, Ruffini E, Marx A, et al. Thymic epithelial tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26(suppl 5):v40-v55.
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