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Thymoma (Follow-up)

eMedicine Pediatrics, 2014

Follow-up Complications Structural problems, such as compression syndromes that involve the bronchi or lungs or superior vena cava syndrome (SVCS), can occur from local spread of benign thymoma, from thymic cysts, or from thymic carcinoma.
Adverse predictive factors include the following: Invasive or metastatic tumor Tracheal or vascular compression Age younger than 30 years Epithelial or mixed histology Tumor size of more than 8 cm The presence of myasthenia gravis (MG) with thymomas is no longer considered a poor prognostic factor and is actually thought to be a favorable prognostic factor.
Based on WHO classification, the 5-year and 10-year survival rates are as follows: Type A - 100% and 95%, respectively Type AB - 93% and 90%, respectively Type B1 - 89% and 85%, respectively Type B2 - 82% and 71%, respectively Type B3 - 71% and 40%, respectively Type C - 23% (5-year survival rate) Recurrence of thymoma can occur after resection.
A study surgical outcomes after recurrence of thymic epithelial tumors in 67 patients showed an overall survival rate at 10 years of 70% in those undergoing re-resection.
For patients with Masaoka stage IVA thymomas, a study of 18 patients reported survival rates at 3 years (91%), 5 years (78%), and 10 years (65%).
These patients underwent multimodality therapy, including surgical resection, preoperative chemotherapy, and even postoperative radiation therapy (in select patients).
Miscellaneous Medicolegal Pitfalls The usual medicolegal pitfalls apply to thymoma and its related conditions, including myasthenia gravis (MG), with regard to misdiagnosis or delayed diagnosis.
Medication adverse effects and surgical complications may also increase the medicolegal risk associated with evaluation and management of this disorder.
  Acknowledgments The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Marion Johnson, MD, to the development and writing of this article.
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