Symptoms and treatment of thymoma

Symptoms and treatment of thymoma.  Thymoma is one of the most common mediastinal tumors.

Thymoma is one of the most common mediastinal tumors. To understand thymoma, we must first know that the thymus is an important immune organ in the human body. It is located in the upper part of the anterior mediastinum behind the sternal stem. The thymus, like other organs, may have benign or malignant tumors. The most common is thymoma.

1. What is thymoma?

Thymoma is a group of mediastinal tumors derived from different thymic epithelial cells and is one of the most common mediastinal tumors. The vast majority of thymoma are located in the thymus of the anterior superior mediastinum. Rarely, it can occur ectopicly in the posterior mediastinum, lower neck, hilar periphery, pleura or lung parenchyma. 10%-45% of patients with thymoma have myasthenia gravis. 10%-30% of patients with myasthenia gravis have thymoma. Thymoma with myasthenia gravis is an important factor for the poor prognosis of thymoma.

2. What are the symptoms of thymoma?

When thymoma is small, it usually does not cause obvious symptoms or no symptoms. Many patients with thymoma go to the ophthalmology department with weakness of the eyelids; another symptom is weakness beginning in the afternoon. As the disease progresses, the tumor grows to a certain size, but it may press on nearby tissues and organs. This is because the patient will experience cough, chest pain, chest tightness, difficulty breathing, and hoarseness. The symptoms persist for a long time, and some patients undergo X-ray examination or some patients find the shadow of mediastinal mass during chest X-ray or chest X-ray. Thymomas that have been overlooked for diagnosis often grow to a considerable size at this time.

When the tumor grows to a certain size, there may even be compression of the innominate vein or superior vena cava obstruction syndrome. Severe chest pain, rapid symptoms aggravated in a short period of time, severe irritating cough, dyspnea caused by pleural effusion, pericardial effusion causing palpitation, shortness of breath, and joint bone pain in the whole body, all suggesting the possibility of malignant thymoma.

Another thymoma may be accompanied by myasthenia gravis. About 1/3 of thymoma is complicated by myasthenia gravis. Myasthenia gravis is an autoimmune disease. Patients will have drooping eyelids, general weakness, unclear speech, and swallowing. Difficulty, blurred vision, etc.;

In addition to myasthenia gravis, thymoma may also be associated with simple red blood cell aplastic anemia, hypoglobulinemia, nephritic nephrotic syndrome, etc., combined with certain syndromes, which is a unique manifestation of thymoma.

3. How to treat thymoma after diagnosis?

After the diagnosis of thymoma is confirmed, the treatment of thymoma, benign or malignant, is mainly surgical treatment. Once diagnosed, surgical resection is recommended according to the situation. If the tumor is not surgically removed in time, the tumor will gradually grow up, which will cause the tumor to oppress the adjacent tissues and organs and produce obvious symptoms; and benign tumors may also become malignant. For most patients with thymoma, the prognosis is still relatively good. For malignant thymoma resected, pathological biopsy can be used to guide postoperative treatment, and postoperative radiotherapy for some resected patients can relieve symptoms, prolong survival and improve quality of life.

4. Can thymoma be minimally invasive surgery?

The answer is yes. In recent years, with the continuous development and improvement of thoracoscopic surgery technology, expanded thoracoscopic thymoma resection has become possible, and due to its unique advantages, it has become the current mainstream way of treating thymoma . Indications for thoracoscopic surgery for thymoma:

① Clinical stage I or II;

②The diameter of the tumor is less than 5 cm;

③ Thymoma is confined to the thymus lobe/has not broken through the thymus capsule;

④ The tumor can be separated from the innominate vein.

5. Compared with traditional treatment methods, what are the advantages of thoracoscopic surgery?

In the past, according to the size of the tumor and the degree of invasion, you can choose all or part of the median sternum incision, anterolateral thoracic incision, sternum enlarged incision, combined anterolateral thoracic incision, or “T”-shaped incision for thymectomy. The traditional open “median sternal approach thymectomy” will leave the patient with a 20cm scar after the operation, which is very traumatic to the human body; if the traditional “transthoracic approach thymoma resection” is used, the intercostal nerve will be injured. It will also bring severe postoperative pain.

The adoption of a new minimally invasive surgical method, namely “thoracoscope enlarged thymectomy”, can ensure complete tumor resection and sweep range, while retaining the bilateral phrenic nerve and intercostal nerve, and protect the patient’s respiratory function , Greatly reduce the surgical damage to the intercostal nerves, muscles, blood vessels and other chest wall soft tissues, significantly reduce postoperative pain, reduce bleeding, shorten the operation time, improve the postoperative quality of life, and shorten the hospital stay. And the incision is generally only 3.0cm, hidden under the armpit, which can fully reflect the advantages of minimally invasive surgery in thoracic surgery.

When severe chest pain occurs and the symptoms get worse in a short period of time, seek medical attention in time to rule out the possibility of malignant thymoma or thymic cancer. Exercise should be appropriate in daily life to enhance self-immunity; pay attention to rest and avoid overwork. It is very important to maintain a good attitude, and to face the disease with a positive attitude. Early diagnosis and early treatment are the key to the prevention and treatment of this disease.

(source:internet, reference only)

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