Abstract
We report three cases of synchronous multiple thymoma diagnosed at a single hospital during the 10 years since 1999. Two were accompanied by myasthenia gravis (MG). In two patients, two thymomas were detected by preoperative computed tomography (CT), and in one, a microthymoma was found incidentally on pathologic examination of a resected specimen for gross thymoma and thymus. The multiple lesions were located in the thymus, and extended thymectomy was performed via median sternotomy in all three patients. The World Health Organization subtypes of the multiple thymomas were identical in each patient; however, all were considered to be primary lesions since the larger one was well encapsulated and each tumor was apparently separated. The Masaoka stage was classified as I/I, I/I, and I/II, respectively. Postoperative clinical courses were uneventful and no recurrence was observed in any of the patients. We reviewed 16 reported cases of synchronous multiple thymoma, and discuss the pathogenesis and treatment of this unusual entity.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Alifano M, Parri SN, Arab WA, Bonfanti B, Lacava N, Porrello C, et al. Limited upper sternotomy in general thoracic surgery. Surg Today 2008;38:300–304.
Kawaguchi K, Usami N, Uchiyama M, Ito S, Yasuda A, Yokoi K. Triple thymoma with different histologic types. J Thorac Cardiovasc Surg 2007;133:826–827.
Maggi G, Casadio C, Cavallo A, Cianci R, Morinatti M, Ruffini E. Thymoma: results of 241 operated cases. Ann Thorac Surg 1991;51:152–156.
Bernatz PE, Harrison EG, Claget OT. Thymoma: a clinicopathologic study. J Thorac Cardiovasc Surg 1961;42:424–444.
Jaretzky A III, Penn AS, Younger DS, Wolff M, Olarte MR, Lovelace RE, et al. Maximal thymectomy for myasthenia gravis. Results. J Thorac Cardiovasc Surg 1988;95:747–757.
Takeuchi S, Osada H, Nishikawa M, Mochizuki A, Takagi M. Resection of multiple thymoma: a case report. Nihon Kyoubushikkann Gakkaizasshi (Jpn J Chest Dis) 1997;35:1025–1028.
Okada M, Tsubota N, Yoshimura M, Miyamoto Y, Sakamoto T. Two cases of synchronous multiple thymoma. Surg Today 1998;28:1323–1325.
Gotoh N, Yokoi K. A case of resected multiple thymoma. Nihon Kokyukigeka Gakkaizassshi (J Jpn Assoc Chest Surg) 2000;14:62–66.
Hirai T, Yamanaka A, Fujimoto T, Takahashi A, Takayama Y, Yamanaka K. Multiple thymoma with myotonic dystrophy. Jpn J Thorac Cardiovasc Surg 2001;49:457–460.
Ishibashi H, Akamatsu H, Sunamori M. Multiple thymoma with myasthenia gravis: report of a case. Surg Today 2003;33:49–51.
Nonami Y, Moriki T. Synchronous independent bifocal orthotopic thymomas: a case report. J Cardiovasc Surg 2004;45:585–587.
Yoneda S, Matsuzoe D, Kawakami T, Tashiro Y, Shirahama H, Ohkubo K, et al. Synchronous multicentric thymoma: report of a case. Surg Today 2004;34:597–599.
Mori T, Nomori H, Ikeda K, Yoshioka M, Kobayashi H, Iwatani K, et al. Three cases of multiple thymoma with a review of the literature. Jpn J Clin Oncol 2007;37:146–149.
Yokota K, Kanzaki M, Miyano H, Ohara T, Ishizawa M. A case of myasthenia gravis with multiple thymoma. Kokyu (Respiratory Research) 2008;27:180–181.
Travis WD, Brambilla E, Müller-Hermelink HK, Harris CC. WHO classification. Pathology and genetics of tumours of the lung, pleura, thymus and heart. Lyon: IARC Press; 2004. p. 146–167.
Chen G, Marx A, Wen-Hu C, Yong J, Puppe B, Stroebel P, et al. New WHO histologic classification predicts prognosis of thymic epithelial tumors: a clinicopathologic study of 200 thymoma cases from China. Cancer 2002;95:420–429.
Inoue M, Starostik M, Zettl A, Ströbel P, Schwarz S, Scaravilli F, et al. Correlating genetic aberrations with World Health Organization-defined histology and stage across the spectrum of thymomas. Cancer Res 2003;63:3708–3715.
Fechner RE. Recurrence of noninvasive thymoma. Cancer 1969;23:1423–1427.
Nomori H, Horio H, Iga R, Kobayashi R, Morinaga S. Recurrence of a stage I thymoma after resection. Nihon Kyoubushikkann Gakkaizasshi (Jpn J Chest Dis) 1996;34:833–836.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Suzuki, H., Yoshida, S., Hiroshima, K. et al. Synchronous multiple thymoma: Report of three cases. Surg Today 40, 456–459 (2010). https://doi.org/10.1007/s00595-009-4080-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-009-4080-z