BACKGROUND. An association between thymoma and second malignancy has been s
uggested but has not been validated. Whether the relation is due to treatme
nt or to other thymoma-associated conditions is unclear.
METHODS. The authors studied 192 consecutive patients with thymoma and comp
ared the incidence of second malignancies with those of 206 patients who un
derwent thymectomy for nonthymomatous conditions and 1426 patients with nas
opharyngeal carcinoma (NPC). Detailed clinicopathologic features of thymoma
patients with second malignancies were described.
RESULTS. Additional malignancies were detected in 15 of 192 patients (8%) d
uring their clinical courses. The risk for those patients was significantly
greater compared with the risk for patients with nonthymomatous conditions
(adjusted odds ratio [OR], 3.81; 95% confidential intervals [95%CI], 1.05-
13.81; P = 0.042) and patients with NPC (adjusted OR, 4.89; 95%CI, 2.26-10.
53; P < 0.0001) after adjustment for age, gender, length of follow-up, myas
thenia gravis, and radiation therapy. The occurrence of second malignancies
did not correlate with histologic type or stage of thymoma, radiation ther
apy, or myasthenia gravis.
CONCLUSIONS. Thymoma is associated with an increased risk of second maligna
ncy. The association cannot be attributed to the effect of thymectomy or ra
diation therapy. Patients with thymoma, even if it is benign, Should be fol
lowed regularly to facilitate the early detection of other malignancies. (C
) 2001 American Cancer Society.