Vincenzo Damiano, Margaret Ottaviano, Irene Tucci, Elide Matano, Sabino De Placido, Giovannella Palmieri
Background: Thymic hyperplasia is a rare differential diagnosis of anterior mediastinal lesions. Histological and radiological criteria are used to distinguish this benign condition from other malignant diseases; it is often associated with Myasthenia gravis. Here we report our monocentric experience of five patients, affected by advanced thymic epithelial tumors (TETs), with a previous diagnosis of thymic hyperplasia.
Methods: Four patients (two female and two male with a median age of 61 years, range, 52–71 years), who went to Rare Tumors Reference Centre of Naples from September 2013 to July 2015, had a previous history of thymic hyperplasia. All patients were affected by Myasthenia Gravis in the young age and for this reason they underwent to radical thymectomy in 1994 in our thoracic surgery department. The diagnosis was confirmed histologically. All of them, after 20 years, received the diagnosis of advanced TET, specifically one patient at stage of disease IVa sec, Masaoka-Koga and B2 histotype sec, WHO 2004, three patients at stage IVb and B3 histotype. They were candidated to first line platinum based chemotherapy, only one patient underwent to radical surgery and adjuvant chemotherapy.
Results: One patient died after 2 years from diagnosis because of septic shock, two patients have a stable disease and one patient is still on treatment.
Conclusion: s: Here we report this experience to underline the importance of a previous diagnosis of thymic hyperplasia. It may be considered as a risk factor for the development of a more aggressive and extended disease due to a possible carcinogenesis model. Further studies are needed.
