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Thymic Hyperplasia
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Thymic Hyperplasia

I was diagnosed in October 2007 with stage IIIC ovarian cancer (one positive lymph node ). My surgery went very well -complete cytoreduction - and then I had 8 rounds of carbo/taxol. My CA-125 after surgery was 16, it dropped to 7 after my first chemo treatment, and since I completed treatment in April 2008 it has been 6. I had my first post-treatment CAT scan in August, and I was told that the scan looked good, and there were a few very small masses showing that they believed to be scar tissue. I recently had another appointment nand asked for a copy of the CAT scan report from August. In addition to the two small masses ( scar tissue ) I was told about, the report states that there was a triangualr mass of thymic tissue in my chest, consistent with thymic hyperplasia. When I asked the docotor about the thymic hyperplasia, he told me that it is very common in children after chemotherapy, but very rare in an adult as old as me ( I'm 50 ). He told me it is nothing to worry about. Well.......not worrying is easier siad than done. I'd like to know what thymic hyperplasia is, what casues it, and what impact ( if any ) it has on my survival. Thanks !
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242604_tn?1328124825
Hi There,
I would agree with your doctor. I am not aware of an association of the thymus with ovarian cancer.
Here is an extremely comprehensive discussion of the thymus gland:
http://www.emedicine.com/med/TOPIC3195.HTM
this link will give you an understanding of definitions, terminology, causes

Ultimately, I always worry about what I do not know that I do not know. So I would suggest a consultation with a pulmonary specialist to go over your scans.Most likely , you will be reassured that this is a normal variant. However, nothing replaces a careful first hand look at the xrays with a chest expert.

In a search of the medical literature, I came across 2 small reports:

1. Cancer. 1985 Oct 1;56(7):1526-8.
Thymic hyperplasia following successful chemotherapy. A report of two cases and review of the literature.Carmosino L, DiBenedetto A, Feffer S.
True thymic hyperplasia is rare in adults. The authors have encountered this entity in two patients who were deemed disease-free following combination chemotherapy for malignant disease. It cannot be assumed that the development of a mediastinal mass or its persistence following chemotherapy is due to recurrent or residual disease. The interrelationship between the immunosuppressive effects of neoplasia and chemotherapy with the resultant thymic overgrowth remains to be clarified.

2. Am J Surg Pathol. 2005 Apr;29(4):496-9.
Low-grade serous carcinoma of the ovary metastatic to the anterior mediastinum simulating multilocular thymic cysts: a clinicopathologic and immunohistochemical study of 3 cases.Moran CA, Suster S, Silva EG.

Three cases of serous borderline tumors of the ovary with areas of serous low-grade carcinoma metastatic to the anterior mediastinum simulating multilocular thymic cysts are presented. The patients are women between the ages of 33 and 50 years. The 3 women had a prior history of primary ovarian neoplasms diagnosed over a period ranging from 3 to 20 years; the 3 patients were in stages IIIA, IIIB, and III. Follow-up radiologic examination revealed the presence of an anterior mediastinal tumor. The 3 patients underwent surgical resection of the mediastinal tumor. Grossly, the mediastinal tumors measured from 7 to 9 cm in greatest diameter and were described as cystic with solid areas. Focal areas of hemorrhage were present, but frank necrosis was not identified. Histologically, all the tumors basically showed similar histopathologic features, namely, those described in multilocular thymic cysts, ie, cystic structures lined by either squamous or low cuboidal epithelium, lymphoid hyperplasia, cholesterol cleft granulomas, and remnants of thymic tissue. In addition, within the cystic structures, there was a neoplastic cellular proliferation with papillary architecture, nuclear atypia, and scattered mitotic figures. Immunohistochemical studies for keratin, MOC31, and CA-125 showed positive staining in tumor cells while placental-like alkaline phosphatase was negative. Two patients remain alive and well after follow-up ranging from 6 to 18 months and 1 patient died of tumor 18 years after initial diagnosis.



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