Carcinoid tumors of the thymus

Three patients with carcinoid tumors of the anterior mediastinum are described. Study of these patients and an analysis of previously reported cases indicates that the thymus is the primary site of these tumors, which are probably related to the presence of Kulchitsky cells in normal thymus. These neoplasms differ clinically and anatomically from conventional thymomas. They occur predominantly in men, are not associated with myasthenia gravis or red-cell hypoplasia, and are more aggressive tumors than thymomas. Histologically, they are similar to carcinoid tumors of other organs and differ from the variable combination of epithelial cells and lymphocytes of thymomas. Although they are usually locally invasive and frequently metastasize, the clinical course is usually protracted. It is probable that the reported examples of Cushing's syndrome related to thymomas were actually associated with thymic carcinoid tumors.