Surgical treatment of thymic cysts and neoplasms in children

Based on experience with 17 patients and review of the literature, complete excision is possible for all benign thymic cysts and neoplasms. Recurrence is rare (2%). Most malignant thymomas in children are epithelial (73%). As with adults, prognosis depends on accurate surgical staging and aggressive surgical intervention. Even the largest tumors can be completely excised removing portions of lung, pleura, diaphragm, and pericardium in continuity as required. Cardiopulmonary bypass may be necessary when the innominate veins or the superior vena cava is involved. Irradiation is required for stage II and stage III lesions. Stage IV patients require irradiation and chemotherapy.