Cancerous tumours of the thymus

A cancerous tumour of the thymus can grow into and destroyit. The tumour can also spread (metastasize) to other parts of the body. Cancerous tumours are also called malignant tumours.

Cancerous tumours of the thymus are rare. Most cancerous tumours of the thymus start in the epithelial cells of the thymus. They are known as a group called thymic epithelial tumours.

Thymoma

Thymoma is the most common cancerous tumour of the thymus. It tends to grow slowly and doesn’t usually spread to areas outside of the thymus. The cancer cells look a lot like normal epithelial cells of the thymus.

When describing thymomas, doctors may use the words non-invasive and invasive.

Non-invasive thymomas have not broken through the covering of the thymus (capsule), but they can stick to nearby organs. They are usually easily removed with surgery.

Invasive thymomas have grown into organs and areas around the thymus and sometimes spread to the lining covering the lungs (the pleura). They can be harder to remove than non-invasive thymomas.

Thymic carcinoma

Thymic carcinoma is a less common cancerous tumour of the thymus. It tends to be an aggressive tumour that grows quickly and has often has spread to other parts of the body when it is diagnosed. The cancer cells look very different from normal thymus epithelial cells.

Thymic carcinoma may be classified as low grade or high grade. Grade depends on how different the cancer cells look and behave compared to normal cells. Low-grade thymic carcinoma often has a better prognosis than high-grade thymic carcinoma.

There are different types of thymic carcinoma. They are named based on how the cancer cells look under a microscope. These include:

  • squamous cell
  • mucoepidermoid
  • undifferentiated
  • small cell carcinoma

Other cancerous tumours

Tumours can start in different types of cells in the thymus. The following cancerous tumours are very rare.

Thymic neuroendocrine tumours (NETs) start in the neuroendocrine cells of the thymus. Like other NETs, thymic NETs can be made up of cells that look and act much like normal cells (well-differentiated). Or thymic NETs can have very abnormal cells and be aggressive tumours that grow very quickly (poorly differentiated).

Thymic lymphomas start in the lymphocytes of the thymus. The most common type of lymphoma that starts in the thymus is primary mediastinal large B-cell lymphoma, a type of non-Hodgkin lymphoma.

Expert review and references

  • Baudin E, Caplin M, Garcia-Carbonero R, Fazio N, Ferolla P, Filosso PL, et al. Lung and thymic carcinoids: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2021: 32(4): 439-451.
  • Cabezon-Gutierrez L, Pacheco-Barcia V, Carrasco-Valero F, Palka-Kotlowska M, Custodio-Cabello S, Khosravi-Shahi P. Update on thymic epithelial tumors: a narrative review. Mediastinum. 2024: 8:33.
  • Girard N, Ruffini E, Marx A, Faivre-Finn C, Peters S. Thymic epithelial tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2015: Supplement 5:v40-v55.
  • Marx A, Chan JK, Chalabreysse L, Dacic S, Detterbeck F, French CA, et al. The 2021 WHO classification of tumors of the thymus and mediastinum: what is new in thymic epithelial, germ cell and meschymal tumors. Journal of Thoracic Oncology. 2021: 17(2): 200-213.
  • Marx A, Chan JK, Chalabreysse L, Dacic S, Detterbeck F, French CA, et al. The 2021 WHO classification of tumors of the thymus and mediastinum: what is new in thymic epithelial, germ cell and meschymal tumors. Journal of Thoracic Oncology. 2021: 17(2): 200-213.
  • Cameron RB, Girard N, Lee PP. Neoplasms of the mediastinum. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, [chapter 32], https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.

Classification of thymoma and thymic carcinoma

Thymoma and thymic carcinoma can be divided into groups based on what the cancer cells look like under a microscope. Along with the stage, this classification helps your healthcare team plan your treatment and predict future outcomes (your prognosis).

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