Section of Thoracic Surgery, Yale School of Medicine, Yale University, 330 Cedar St., New Haven, CT 06520, USA.
Chin Med J (Engl). 2013;126(11):2186-91.
To review the presentation, diagnosis, staging and treatment of thymoma.
Data were obtained from papers on thymoma published in English within the last 30 years. No formal systematic review was conducted, but an effort was made to be comprehensive.
Studies were selected if they contained data relevant to the topic addressed in the particular section. In particular, standards adopted by the International Thymic Malignancies Interest Group through a formal process of achieving worldwide consensus are featured. Because of the limited length of this article, we have frequently referenced recent reviews that contain a comprehensive amalgamation of literature rather than the actual source papers.
Thymomas are rare malignant tumors. They account for about half (47%) of anterior mediastinal tumors. About one third of these are associated with myasthenia gravis. Computed tomography with intravenous contrast is the standard diagnostic modality. Thymomas appear as round or oval masses in early stages but irregular shapes with calcifications occurring in later stages. They can invade surrounding structures including mediastinal fat, pleura, major blood vessels and nerves. Fine needle aspiration, core needle biopsy or open biopsy is used to obtain tissue diagnosis. Masaoka-Koga classification is currently used to stage thymomas. All thymomas should be considered for resection due to their malignant potential. A complete resection is a major prognostic factor and every effort should be made to achieve this even if this means resection and reconstruction of a major thoracic structure. Median sternotomy is the standard approach for thymoma resection. A number of minimally invasive techniques are used in selective centers. While stage I and II tumors undergo primary surgery, preoperative chemotherapy appears to increase the chances of complete resection for stage III and IVa tumors. Postoperative radiation could be considered for patients with residual disease. Excellent 5 and 10-year survival rates are noted for completely resected early stage thymomas.
Thymic malignancies are rare tumors. Standards have recently been achieved to allow better communication and promote collaborative research. Surgical resection is the mainstay of treatment, but a multimodality approach is useful for many patients.
综述胸腺瘤的临床表现、诊断、分期和治疗。
英文文献，检索时限为 30 年以内，关于胸腺瘤的英文文献。未进行正式的系统评价，但努力做到全面。
如果研究包含与特定部分主题相关的数据，则选择该研究。特别强调采用国际胸腺恶性肿瘤兴趣小组（International Thymic Malignancies Interest Group）通过正式达成全球共识的过程中采用的标准。由于本文篇幅有限，我们经常引用包含综合文献综述的最近综述，而不是实际的原始文献。
胸腺瘤是罕见的恶性肿瘤。它们占前纵隔肿瘤的一半（47%）左右。其中约三分之一与重症肌无力有关。静脉内对比增强计算机断层扫描是标准的诊断方法。胸腺瘤在早期阶段呈圆形或椭圆形肿块，但在晚期阶段呈不规则形状并伴有钙化。它们可以侵犯周围结构，包括纵隔脂肪、胸膜、大血管和神经。细针抽吸、芯针活检或开放活检用于获得组织诊断。Masaoka-Koga 分期目前用于胸腺瘤分期。由于其恶性潜能，所有胸腺瘤都应考虑切除。完全切除是主要的预后因素，即使这意味着切除和重建主要的胸部结构，也应尽一切努力实现这一目标。正中胸骨切开术是胸腺瘤切除的标准入路。在一些选择性中心采用了一些微创技术。虽然 I 期和 II 期肿瘤行原发性手术，但术前化疗似乎增加了 III 期和 IVa 期肿瘤完全切除的机会。对于有残留疾病的患者，可以考虑术后放疗。完全切除的早期胸腺瘤的 5 年和 10 年生存率均较好。
胸腺癌是罕见的肿瘤。最近已经达成了标准，以允许更好的沟通和促进合作研究。手术切除是治疗的主要方法，但对于许多患者来说，多模式方法是有用的。
