Thymic Tumors Clinical Presentation

Updated: Feb 22, 2021
  • Author: Dale K Mueller, MD; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
  • Print
Presentation

History and Physical Examination

Many mediastinal tumors and cysts produce no symptoms and are found incidentally after chest radiography or other imaging studies of the thorax. Symptoms are present in approximately one third of adult patients with any type of mediastinal tumor or cyst but are observed more commonly in pediatric patients, nearly two thirds of whom present with some symptoms. In adults, asymptomatic masses are more likely to be benign.

Approximately 50% of individuals presenting with thymomas are clinically asymptomatic. When symptoms are present with these neoplasms, they may be manifested as local or systemic symptoms or a combination of both. Ill-defined chest pain, cough, and shortness of breath are the most commonly identified associated symptoms.

More severe symptoms (eg, superior vena cava syndrome [SVCS], phrenic nerve paralysis, or recurrent laryngeal nerve involvement resulting in hoarseness) are less common but are often indications of malignant disease. Invasion of the chest wall or pleura can also occur with a malignant neoplasm. This can produce persistent pleural effusions and a significant amount of local pain. Other constitutional symptoms associated with thymoma in almost 20% of patients include weight loss, fever, fatigue, and night sweats.

Mediastinal tumors that produce bioactive substances are associated with symptoms produced by those substances (see Pathophysiology).