Thymoma: Radiologic-pathologic Correlation

Thymoma is the most common primary neoplasm of the thymus. The majority of thymomas are encapsulated masses and exhibit a benign behavior. Less frequently, thymomas may be locally invasive, or rarely they may metastasize to distant sites. The usual clinical presentation is that of an anterior mediastinal mass found incidentally in an asymptomatic patient. The variable gross features of thymoma and the potential for local invasion result in a variety of radiologic appearances. The most common radiologic manifestation is a rounded, soft-tissue mass of the anterior superior mediastinum. Computed tomography and magnetic resonance imaging typically show a prevascular mediastinal mass of variable size and may be helpful in the evaluation of adjacent structures in cases of invasive thymoma. The treatment of choice is complete surgical excision. Radiation therapy and chemotherapy may be used adjunctively to surgery in the treatment of invasive tumors. The prognosis of encapsulated thymoma is generally favorable. Invasive tumors are associated with a worse prognosis but may respond to radical resection.