Thymoma/thymic carcinoma Flashcards
masaoka staging of thymoma: TNM not preferred: Stage II
IIA: microscopic transcapsular invasion
IIB: macroscopic invasion into surrounding fatty tissue or grossly adherent to but not through mediastinal pleura or pericardium
stage III masaoka
macroscopic invsion into neighbouring organs (pericardium, great vessels, lung)
A: without great vessel invasion
B: with invasion of great vessels
Stage IV: masaoka
A: pleural or pericardial dissemination
B: lymphogenous or hematogenous metastasis.
in few cancers staging system other than TNM is preferred
thymus
testicular
Paraneoplastic syndrome associated with thymoma
myasthenia gravis
pure red cell aplasia
rheumatoid arthritis
scleroderma
addison disease
myocarditis
hypertension may be caused by which of the mediastinal tumor
phemochromocytoma
chemodectoma
neuroblastoma
ganglioneuroma
Differential diagnosis of anterior mediastinal mass
thymic tumors
thymomas
thymic carcinomas
thymic cysts
carcinoids
lymphomas
germ cell tumors: seminoma, non seminoma, CCA
parathyroid adenoma
lipoma .
liposarcomas
D/D of middle mediastinal tumor
lymphomas
cysts
pericardial mass
thoracic duct
carcinoma
cardiac and pericardial tumor
lymphadenopathy
inflammatory
posterior mediastinal mass
lymphomas
neurogenic tumor
peripheral nerve
schwannomas
neurosarcomas
neuroblastomas
paraganglia
mesenchymal tumors
endocrine tumor
esophageal tumor and cyst
Radiation dose for thymic carcinoma/thymoma: unresectable disaese
60-70 gy
radiation dose for thymoma: adjuvant
45-50 gy for clear/close margin
54 gy for microscopically positive margin
60-70gy for gross residual disease