Thymic Tumors

Posted by anotherfinemass @anotherfinemass, Jan 16, 2019

As the owner of a fairly large thymic tumor, I have been trying to and understand the condition, currently acceptable treatments, and the various risks associated with those treatments (and non-treatment). The basics of my initial understanding are:

(1) Thymic tumors are relatively rare.
(2) Except in the case of thymic hyperplasia, thymic tumors are cancerous.
(3) Thymic hyperplasia is extremely rare in adults.
(4) The cancerous thymic tumors are thymomas, thymic carcinomas, and neuroendocrine tumors.
(5) The most dangerous and least understood of those are neuroendocrine tumors.
(6) In almost all instances, surgical removal of the thymic tumor is the standard treatment.
(7) The most common and most desired goal of surgery is a full resection of the tumor.
(8) Full resection of the tumor is important to achieve satisfactory long-term survival.
(9) Biopsies of thymic tumors are usually performed at the time the tumor is being surgically removed.

Some of the most common conditions that are associated with thymic tumors and the operations conducted to remove them are:

(1) Phrenic Nerve damage;
(2) Sympathetic Chain damage;
(3) Sternal wound infections;
(4) Damage to the superior vena cava and/or other nearby veins;
(5) Recurrent laryngeal Nerve damage;
(6) Horner Syndrome, and;
(7) Myasthenia gravis.

Of greatest concern in considering the above is that just as the tumors are relatively rare, so are surgeons that specialize in resecting the tumors. And not being independently wealthy, resources for consults and second or third opinions are limited. This has given rise to the question of what is the proper or commonly recognized protocol to engage surgeons.

More specifically, many thoracic surgeons do not work with thymic tumors. That being the case, I have tried to get answers to the following questions before making an appointment for a consult:

(1) How many thymic tumors (approximately) have you removed or debulked in your career?
(2) Of those, in how many cases was the tumor completely removed and how many debulked?
(3) Of all those procedures how many (approximately) were for which of the four types of tumor?
(4) What were your best and worst results?
(5) The mass in my chest now measures ## cm x ## cm x ##.# cm in craniocaudal, mediolateral and anteroposterior dimensions. Have you ever operated on a mediastinal mass this size?
(6) Have any of the several conditions listed above have been common (occurring in more than 50%) in your patients, and if so, which conditions?

My limited experience in this pursuit of these answers is that the surgeon's assistant says I need to schedule an appointment to discuss those matters with the surgeon. However, that leaves you in a "chicken or the egg" situation where you need a referral to see a surgeon, but without the answers, you aren't sure if you want to use the referral for that surgeon! And sending unsolicited emails has not been productive.

Has anyone else dealt with this? What was your process? What's the process at Mayo? (I am not located near a Mayo Clinic.) Also, please feel free to supplement the information above or correct any misinformation (provided unknowingly).

Thanks in advance.

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@hopeful33250

Your broken heart is easy to understand, @rosez. Our environment does not allow us much travel, does it? I really appreciate your posting about the date of your daughter's surgery. I will certainly pray for her.

Does your daughter have a good support system in California? Family, friends, church, etc.?

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Thank God she has a wonderful mother-in-law. My daughter and her family have moved into her home. She also has some friends close by.

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@rosez

Thank God she has a wonderful mother-in-law. My daughter and her family have moved into her home. She also has some friends close by.

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I know that you would like to be with your daughter, @rosez, during this time, but you must be grateful for her mother-in-law and the friends that she has. It sounds as if she is well cared for! That is a great comfort to her and to you!

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This was recently posted by @rosez in another discussion regarding her daughter's surgery for thymic cancer.

"I can't believe that my life has gone from bad to worse. My husband has an inoperable brain tumor and now so does my daughter. She is only 39 and has 3 1/2 year old twin girls. Her surgery was on Friday but they were unable to do anything. The tumor was rock hard and if they tried to remove it, she could possibly die. They didn't even remove her cancerous lymph nodes in her neck."

As I recall @rosez they were looking to replace a heart valve. Is this what they were not able to do?

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@hopeful33250

This was recently posted by @rosez in another discussion regarding her daughter's surgery for thymic cancer.

"I can't believe that my life has gone from bad to worse. My husband has an inoperable brain tumor and now so does my daughter. She is only 39 and has 3 1/2 year old twin girls. Her surgery was on Friday but they were unable to do anything. The tumor was rock hard and if they tried to remove it, she could possibly die. They didn't even remove her cancerous lymph nodes in her neck."

As I recall @rosez they were looking to replace a heart valve. Is this what they were not able to do?

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I have never heard of a rock hard tumor, one that is not removable. How does this happen? What is a thymic tumor? I will go back and read this thread, but how rare is this situation?

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@susu2

I have never heard of a rock hard tumor, one that is not removable. How does this happen? What is a thymic tumor? I will go back and read this thread, but how rare is this situation?

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Only 400 people a year get this cancer

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@susu2

I have never heard of a rock hard tumor, one that is not removable. How does this happen? What is a thymic tumor? I will go back and read this thread, but how rare is this situation?

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Hello @susu2

Thymic cancer is quite rare. Here is a brief explanation from WebMD, https://www.webmd.com/cancer/thymoma-thymic-carcinoma.

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@hopeful33250

This was recently posted by @rosez in another discussion regarding her daughter's surgery for thymic cancer.

"I can't believe that my life has gone from bad to worse. My husband has an inoperable brain tumor and now so does my daughter. She is only 39 and has 3 1/2 year old twin girls. Her surgery was on Friday but they were unable to do anything. The tumor was rock hard and if they tried to remove it, she could possibly die. They didn't even remove her cancerous lymph nodes in her neck."

As I recall @rosez they were looking to replace a heart valve. Is this what they were not able to do?

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They were hoping to replace a valve and lymph nodes that were malignant. They were unable to do either

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@rosez

They were hoping to replace a valve and lymph nodes that were malignant. They were unable to do either

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Oh, @rosez, how disappointing! How is your daughter feeling? She must be very tired. Are there other treatment options available to her?

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@hopeful33250

Oh, @rosez, how disappointing! How is your daughter feeling? She must be very tired. Are there other treatment options available to her?

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My daughter passed away tonight.

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@rosez

My daughter passed away tonight.

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Oh @rosez, my heart aches for you and your family. That was so sudden. Please know that you are not alone.

Many members will welcome you in the Loss & Grief group https://connect.mayoclinic.org/group/loss-grief/

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