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Thymoma and Thymic Cancer

Thymomas and thymic carcinomas are rare cancers oftentimes incidentally discovered on the anterior mediastinum. The thymus gland is mainly responsible for immune development within the first year of life, then decreases in function and size afterward. Thymic tumors are masses that arise from the thymus; thymomas and thymic carcinomas are the most common cancers that develop from the thymus. Thymomas are typically asymptomatic and surgical removal is the cornerstone of therapy. Thymic carcinomas are usually more aggressive and may not be resectable.

Myasthenia gravis is an autoimmune condition that causes antibodies to form against acetylcholine receptors on nerve endings thus causing progressive weakness and droopy eyelids, and in advanced cases, difficulty breathing. Approximately 2/3 of patients with myasthenia gravis have associated enlargement of the entire thymic gland (Thymic Hyperplasia) or a distinct thymic tumor (Thymoma). Removal of the thymus gland is known to improve symptoms of myasthenia gravis whether or not the thymus enlarged.

Symptoms of thymic tumors:

  • Symptoms associated with myasthenia gravis such as weakness, facial and/or eye drooping, shortness of breath
  • Cough
  • Chest pain
  • Many times, patients are asymptomatic

Surgical interventions:

Thymic tumors are traditionally removed via sternotomy (where the breast bone is cut). While our surgeons can perform this approach, as our service specializes in minimally invasive/thoracoscopic surgery (VATS) or robotic assisted surgery, we generally use either of these approaches to remove a thymic tumor.  

A video assisted surgery is a minimally invasive lung surgery where the surgeon creates multiple small incisions in the chest and uses a video camera that sees into the chest in order to perform the procedure. Performing a VATS procedure will accomplish the same anatomic dissection as an open thoracotomy approach.
Robot assisted thoracic surgery is a minimally invasive lung surgery similar to a VATS, but uses a unit (or “robot”) with multiple moveable arms that are controlled by the surgeon at a separate console.