Treatment of early stage thymic tumors: surgery and radiation therapy

Tumors of the thymus are an uncommon entity, constituting 30% and 15% of anterior mediastinal masses in adults and children, respectively. The majority of these tumors are thymomas, with thymic carcinomas less common, and thymic carcinoids exceedingly rare. Recognition of the distinct clinicopathologic behavior of various thymic neoplasms is crucial to providing optimal treatment. Evidence guiding the treatment of early stage thymic tumors is limited secondary to the low incidence and resulting lack of randomized data. Proper management requires a careful analysis of the available literature with particular attention paid to limitations of the existing studies. This article provides a discussion of the presentation, evaluation, diagnosis, surgical techniques, and treatment outcomes relevant to early stage thymomas, thymic carcinomas, and thymic carcinoid tumors. The role of radiation therapy in the management of early stage thymic tumors remains controversial and is discussed in detail.