Thymic carcinoma - Analysis of nineteen clinicopathological studies

Background: Primary thymic carcinomas are rare tumours with nonuniform mana gement protocols and poor prognosis due to delayed diagnosis and highly mal ignant behaviour. This review summarises the major clinicopathological stud ies to assess more fully the prognostic importance of tumour histology and staging as well as treatment benefit. Methods: A Medline search from 1966 t o date was carried out and relevant references gleaned from these. Nineteen clinicopathological studies form the core of this review. Demographic data and clinical features were examined in all studies. Correlation of outcome with histology was possible in fifteen of the studies and with tumour stag ing in thirteen. Results: Thymic carcinomas occur most commonly in the fift h to sixth decades of life, usually presenting with symptoms of space occup ation or invasion. Paraneoplastic syndromes are rarely associated, except w ith the well differentiated thymic carcinoma. Of 140 thymic carcinomas. 40 were squamous cell, 19 were spindle cell and 16 were lymphoepitheliomalike. Completely resected stage I and II tumours demonstrated the best survival. Conclusions: Complete surgical resection is taken to be the desired treatm ent, but the continued high mortality and relapse rates and the variable be nefit of adjuvant therapies challenge this strategy.