Thymoma: a review of the clinical and pathological findings in 65 cases

Although rare, thymoma is the most common tumour of the anterior mediastinum. In an effort to assess the clinical and pathologic characteristics of this tumour and to determine whether clinicopathologic stage or histopathologic classification correlates with clinical outcome, in the Department of Pathology and the Department of Surgery at the University of Saskatchewan we reviewed all cases of thymoma registered in the province of Saskatchewan using the database of the Saskatchewan Cancer Centre.

In 65 patients with a diagnosis of thymoma or thymic carcinoma identified from the Saskatchewan Cancer Centre database between Jan. 1, 1960, and Dec. 31, 2000, we studied the presentation, diagnostic investigations, therapeutic interventions, tumour size, postoperative course, clinical stage, histopathologic classification, disease recurrence and mortality.

Of the 65 patients, 17 (26%) were asymptomatic and 11 (17%) had symptoms consistent with myasthenia gravis. Surgical resection is most commonly performed through a median sternotomy and frequently requires en bloc resection of one or more adjacent structures. The overall survival of patients with thymomawas found to correlate with the clinical stage as described by Masaoka and colleagues and with complete tumour resection. A trend to clinicopathologic correlation was observed when applying the histologic classification systems of Suster and Moran and the World Health Organisation, but this trend was not statistically significant.

Thymoma is a rare tumour with a variable clinical presentation. Clinical outcome correlates with clinical stage and the ability to achieve complete tumour resection.