Thymoma

Thymoma

A thymoma is a rare tumor of the mediastinum that arises from the thymus and is benign in most cases. Men and women are equally likely to be affected by a thymoma. The tumor is usually easy to treat, with a thymoma usually being surgically removed as part of a resection.

What is a thymoma?

A thymoma is a rare tumor disease of the thymus, which in most cases (about 75 percent) is classified as benign. The thymus is located near the heart, in the front area of ​​the mediastinum and, as the primary organ of the lymphatic system, is important for the development and differentiation of certain T-lymphocytes in childhood. For undescended testicles dictionary definitions, please visit foodanddrinkjournal.com.

The symptoms characteristic of a thymoma, such as coughing, a feeling of pressure, dysphagia (difficulty swallowing), cardiac dysfunction, hoarseness or shortness of breath, usually only manifest themselves at a later stage of the disease, when the thymoma narrows and damages neighboring structures, especially the esophagus and trachea, due to its size.

Causes

The causes of a malignant (malignant) thymoma or thymus carcinoma have not yet been clarified. The only thing that is certain is that the tumor arises from a degenerated cell that multiplies and damages the surrounding structures as it grows.

In addition to genetic factors, certain environmental factors such as pollutants and toxins as well as radiation are also discussed as triggers for this degeneration process. In contrast, benign thymomas are often associated with certain diseases. Myasthenia gravis (autoimmune disease) occurs together with a thymoma in about 20 to 40 percent of cases, although the exact connection between these diseases has not been clarified.

It is assumed that the dysregulated antibodies that attack the body’s own muscle cells in myasthenia gravis could come from the thymus. In addition, anemia (pure red cell aplasia), hypogammaglobulinemia (lack of antibodies), polymyositis (inflammation of the skeletal muscles), thyroiditis (inflammation of the thyroid gland) and Sjögren’s syndrome (autoimmune disease) are associated with a benign thymoma.

Symptoms, Ailments & Signs

Those affected usually only report symptoms to a doctor when the disease has progressed. It is symptomatic that the tumor displaces or grows into another tissue. At first, signs are sometimes misinterpreted. Conventional medication then remains ineffective and promises no cure. Depending on the location of the thymoma, different symptoms arise.

If the tumor presses on the esophagus, patients complain of difficulty swallowing. If shortness of breath occurs, the trachea is usually narrowed. A persistent cough is then encountered. In both cases, those affected regularly report pressure in the chest area. If, on the other hand, persistent hoarseness becomes noticeable, the cervical nerves are usually paralyzed. If the tumor attacks the heart, there is a risk of life-threatening functional disorders.

The characteristic effects are accompanied by general phenomena resulting from the weakening of the organism. In principle, patients tire unusually quickly without having previously exhausted themselves physically. The body is susceptible to diseases, which throws everyday life into confusion and requires compliance with hygienic standards. It is not uncommon for the weight to drop within a few months. The he| Muscle strength decreases. Long walks can become torture. Sudden dizziness threatens everywhere.

Diagnosis & History

The diagnosis of a thymoma is based on the characteristic symptoms in the context of a medical history and physical examination. The diagnosis is backed up by imaging procedures such as an X-ray examination, an MRT (magnetic resonance imaging) or CT (computed tomography).

Imaging methods can also be used to make statements about localization, size, stage and impairment of the surrounding tissue structures. A biopsy with subsequent histological (histological) analysis, which serves to differentiate between malignant and benign thymoma, is usually only carried out as part of a surgical tumor resection (removal of the tumour), since the thymus is in an unfavorable position and is difficult to access.

As a rule, the course and prognosis are good for both benign and malignant thymoma, depending on the time of diagnosis and the stage of the tumor disease, and around 90 percent of those affected are still alive five years after diagnosis.

Complications

Thymus tumors are benign in about three quarters of all cases. With timely treatment, no complications are usually to be expected. However, a recurrence cannot be ruled out. Because thymoma are slow-growing tumors, it can take up to 10 years for the tumor to return after treatment seems successful. Patients therefore have to attend regular check-ups over a long period of time.

If the tumor is not treated in time, the typical symptoms such as shortness of breath, chest pain and heart problems often become very severe and significantly impair the patient’s quality of life. If the tumor is discovered too late, it is also often necessary for its size to be reduced with chemotherapy before surgery can be performed.

Chemotherapy is often associated with a number of very unpleasant side effects, in particular nausea, vomiting and loss of scalp hair. In some cases, radiation can damage the heart or lungs. Complications can also occur if the tumor grows into surrounding organs or metastasizes.

The latter is particularly dangerous in the case of the rather rare malignant thymomas. In these cases, chemotherapy or radiation therapy is almost always required. Fatalities are rare, but cannot be completely ruled out.

When should you go to the doctor?

A doctor should be consulted if there is a steady increase in discomfort, a feeling of illness or inner fatigue. If there is a decrease in physical strength, a loss of mental performance and a lower resilience, it is advisable to clarify the cause. General functional disorders, general weakness, an increased need for sleep and irregular heart rhythms must be examined and treated. Headaches, hoarseness, restricted breathing or swallowing are signs of a health problem.

If muscle strength decreases, everyday obligations can no longer be met or if the person concerned experiences a restriction in carrying out the usual sporting activities, there is a need for action. Heart palpitations, dizziness, restricted mobility and exhaustion are further signs of an existing illness. If the affected person suffers from changes in the complexion, hoarseness or increasing psychological problems and behavioral problems, a doctor should be consulted.

If the zest for life decreases continuously over a longer period of time, if there is a withdrawal from social and community life or if the person concerned suffers from rapid irritability, the observations should be discussed with a doctor. In many cases, emotional and mental problems indicate the presence of a physical impairment. Extensive investigations are necessary to determine the cause of the symptoms.

Treatment & Therapy

The therapeutic measures for a thymoma depend on the stage of the disease. If there is a small thymoma limited to the thymus, the tumor with the surrounding lymph nodes and the adjacent connective and fatty tissue are surgically removed (resection).

In the more advanced stages of a thymoma, additional radiation therapy measures are used to prevent recurrence (recurrence of the tumour). In some cases, such as when there is metastasis (9 percent of cases) or the patient is in a very poor general condition, chemotherapeutic measures are also used.

Even with large thymomas, the tumor can first be reduced as part of chemotherapy before it is surgically removed. In some cases, combined therapy with a somatostatin analog (synthesized growth hormone), which interferes with tumor development and delays its growth, and cortisone is indicated for those affected in whom resection has been ruled out and chemotherapeutic and/or radiotherapeutic measures have been unsuccessful.

However, this therapeutic approach is still being researched as part of clinical tests. Regular follow-up and control examinations using imaging methods as well as blood tests for the early detection and treatment of recurrences are an essential part of successful thymoma therapy, since thymoma have a high local recurrence rate.

Prevention

Since the causes of a thymoma have not been clarified, there are no preventive measures to date. Those affected by diseases with which a thymoma is associated (especially myasthenia gravis) should be checked for an underlying thymoma at an early stage.

Aftercare

Thymomas can be both benign and malignant. For this reason, regular follow-up care after the actual treatment is extremely important. It should also be noted that the local recurrence rate of thymomas is high. New manifestations of the tumor can still appear ten years after surgical removal, which makes long-term monitoring necessary. One of the most common secondary tumors or secondary carcinomas is non-Hodgkin lymphoma, which often occurs after a thymoma.

Follow-up care of the thymoma after cancer treatment has been completed includes check-ups that take place at regular intervals. The doctor carries out imaging examinations. Blood tests are also done. In this way, possible recurrences can be diagnosed early and treated accordingly.

During the aftercare period, the patient attends a check-up every three months for the first two years. As part of this, the doctor looks at the patient’s medical history and performs a thorough physical examination. Computed tomography (CT) of the thorax (chest) is also recommended at 12-month intervals.

In this way, local recurrences can be effectively detected with these methods. It is advisable to have the follow-up examinations carried out by the thoracic surgeon who was previously responsible for treating the tumour. In the case of proven myasthenia, examinations should also be carried out by a neurologist.

You can do that yourself

Medical treatment and care is the top priority for patients with a thymoma. Self-help measures can support medical interventions, but should not remain the sole means. Adequate medical therapy is of the utmost importance in the presence of a thymoma, since the disease is malignant in some cases and thus poses a threat to the lives of those affected.

Therefore, it is in the interest of patients with thymoma to undergo all check-ups offered by various specialists and to actively participate in the treatment of the disease. For example, prescribed medicines must be taken exactly as prescribed and any side effects must be reported to the doctor immediately.

In some cases, removal of the thymoma, and sometimes the entire thyroid, is required. This is particularly necessary if the tumor is in an advanced stage. The patients prepare themselves as well as possible for this operation by taking care of themselves physically and mentally, avoiding stress, following a healthy diet and avoiding stimulants such as cigarettes and alcohol.

Even after the surgical procedure, they pay attention to resting their bodies and undergo all check-up and follow-up examinations by the doctor so that any complications can be treated in good time.

Thymoma