Pathological features of thymoma and thymic carcinoma with therapeutic implications

The prognosis of patients with thymomas (TMs) and thymic carcinomas (TCs) is currently mainly determined by tumor stage, resectability, resection status and, to some extent, by histotype, while molecular tumor markers play a minor role. However, meticulous clinical, imaging and serological studies, eventual followed by needle biopsy (e.g., to exclude lymphoma or germ cell tumors) are indispensable prior to the establishment of any therapeutic concept. Once surgery has been performed, classical pathological features of the resection specimen are the major determinants for subsequent therapeutic decision in almost all TMs and TCs. Predictive molecular markers will play an increasingly important role in the future, as exemplified by the rare TCs with KIT and NUT mutations and those thymic cancers that are susceptible to immune checkpoint inhibitors.