title: Primary intrapulmonary thymoma: a systematic review.
abstract: OBJECTIVE
  This article reviews the literature on the clinical features, diagnosis and management of primary intrapulmonary thymoma.
  
  
  METHODS
  Medline, Embase and Cochrane Library searches were performed on all relevant Anglo-Saxon language articles. The search words included "primary pulmonary thymoma" and "intrapulmonary thymoma". Secondary references were obtained from key articles. Prognostic and treatment strategies were analyzed by the Kaplan-Meier method, comparisons between curves were made using log rank test.
  
  
  RESULTS
  The searches yielded 25 cases of primary intrapulmonary thymoma. Median follow-up was 9 months (1 day to 13 years). At follow-up, 14 patients were tumor free, one patient had a local recurrence 8 years after radiotherapy, one patient responded favorably to radiotherapy, six patients died and three patients were lost to follow-up. The presence of a paraneoplastic syndrome decreased survival (P=0.02), however, histological subgroup (P=0.216), clinical stage (P=0.63) and tumor size (P=0.288) did not affect survival. Survival in surgically managed patients was significantly better than in conservatively managed patients (P=0.039). Adjuvant radiotherapy did not provide any benefit (P=0.4).
  
  
  CONCLUSIONS
  Complete resection of primary intrapulmonary thymomas appears sufficient in non-malignant tumors. Because of the risk of late local recurrence, long-term regular clinical follow-up is warranted.
authors: Department of Cardiovascular Surgery, University Hospitals of Geneva, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. patrick.myers@hcuge.ch
authors: P O
authors: PO
authors: Myers
authors: N
authors: N
authors: Kritikos
authors: M
authors: M
authors: Bongiovanni
authors: F
authors: F
authors: Triponez
authors: S
authors: S
authors: Collaud
authors: J-C
authors: JC
authors: Pache
authors: J H
authors: JH
authors: Robert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002828:Choristoma; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011379:Prognosis; D011878:Radiotherapy; D013945:Thymoma / Q000175:diagnosis / Q000628:therapy; D013953:Thymus Neoplasms / Q000175:diagnosis / Q000628:therapy