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MINI REVIEW article

Front. Surg.
Sec. Thoracic Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1467789
This article is part of the Research Topic Surgical Treatment of Thymic Epithelial Tumor and Myasthenia Gravis View all articles

Surgical Treatment of Thymic Epithelial Tumor and Myasthenia Gravis

Provisionally accepted
Gizem Ozcibik Isik Gizem Ozcibik Isik 1Akif Turna Akif Turna 2*
  • 1 Faculty of Medicine, Istanbul University Cerrahpasa, Istanbul, Türkiye
  • 2 Istanbul University-Cerrahpasa, Istanbul, Türkiye

The final, formatted version of the article will be published soon.

    Thymic epithelial tumors originate from the epithelial cells of the thymus and are typically diagnosed during the 5th and 6th decades of life. The incidence is consistent between men and women, averaging 1.7 cases per year. Thymomas, neuroendocrine tumors, and thymic carcinomas are subtypes of thymic epithelial tumors, with thymomas being the most prevalent (75-80%) and thymic carcinomas following at 15-20%. Thymoma and thymic carcinoma exhibit distinct disease courses; thymomas grow slowly and are confined to the thymus, while thymic carcinomas demonstrate rapid growth and metastasis. Overall survival rates vary, with a 78% 5-year survival rate for thymoma and a 30% rate for thymic carcinoma. Thymic epithelial tumors may be linked to paraneoplastic autoimmune diseases, including myasthenia gravis, hypogammaglobulinemia, pure red cell aplasia, Cushing's syndrome, systemic lupus erythematosus, and polymyositis. Staging of thymic epithelial tumors can be done according to Masaoka-Koga and/or TNM 8th staging systems. The treatment algorithm is primarily determined by resectability, with surgery (Extended Thymectomy) serving as the foundational treatment for early-stage patients. Adjuvant radiotherapy or chemotherapy may be considered following surgery. In advanced or metastatic cases, chemotherapy is the first-line treatment, followed by surgery and radiotherapy for local control. Myasthenia gravis, an autoimmune disease presents with progressive muscle fatigue and diplopia. Treatment includes cholinesterase inhibitors and immunotherapy agents, with extended thymectomy serving as an effective surgical option for drug-resistant cases. Minimally invasive approaches (video-assisted thoracoscopic surgery or robot-assisted thoracoscopic surgery) have demonstrated comparable oncological outcomes to sternotomy, highlighting their effectiveness and reliability.

    Keywords: Thymic epithelial tumor, Myasthenia Gravis, Thoracic Surgery, Minimal invasive surgery, Thymoma, Thymic carcinoma, Thymectomy

    Received: 20 Jul 2024; Accepted: 30 Sep 2024.

    Copyright: © 2024 Ozcibik Isik and Turna. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Akif Turna, Istanbul University-Cerrahpasa, Istanbul, Türkiye

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