title: Thymic carcinoma in children: a report from the Polish Pediatric Rare Tumors Study.
abstract: BACKGROUND
  Invasive thymomas and thymic carcinomas are rare tumors jointly accounting between 0.2% and 1.5% of malignancies in adults. They are usually at an advanced stage when diagnosed and have both high recurrence and poor survival rates. In this report, the aim is to explore our experience in the treatment of thymic carcinomas in Polish children.
  
  
  METHODS
  The clinical data of nine children with thymic carcinomas, treated between 1992 and 2008 in the Polish oncological and surgical centers was retrospectively analyzed.
  
  
  RESULTS
  In five cases, presenting symptoms resulted from the compression of the respiratory ways by the mediastinal tumor. In two children paraneoplastic autoimmune syndromes were associated with thymic carcinoma. In accordance with the Masaoka classification, two patients had stage II, five had stage III, and two had stage IV of the disease. Diagnostic biopsy of mediastinal tumor was performed on eight patients and one underwent complete primary resection and subsequently received radiotherapy; he has passed 11 years since the conclusion of therapy. Six patients received multi-drug chemotherapy with or without steroids. Delayed surgery was performed in four children (R0-2, R1-1, and R2-1). After complete resection, one child received chemotherapy. In three patients, chemotherapy and radiotherapy was administered. Seven patients died, including six due to progression of the disease with the other as a result of complications following chemotherapy; only two patients classed at stage II remain alive.
  
  
  CONCLUSIONS
  Most thymic tumors in pediatric patients are inoperable at diagnosis, which results in poor prognosis. Improved chemotherapy approaches are needed.
authors.affiliation: Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University, Gdansk, Poland. tsten@amg.gda.pl
authors.forename: Teresa
authors.initials: T
authors.lastname: Stachowicz-Stencel
authors.forename: Ewa
authors.initials: E
authors.lastname: Bien
authors.forename: Anna
authors.initials: A
authors.lastname: Balcerska
authors.forename: Jan
authors.initials: J
authors.lastname: Godzinski
authors.forename: Anna
authors.initials: A
authors.lastname: Synakiewicz
authors.forename: Wojciech
authors.initials: W
authors.lastname: Madziara
authors.forename: Marta
authors.initials: M
authors.lastname: Perek-Polnik
authors.forename: Jarosław
authors.initials: J
authors.lastname: Peregud-Pogorzelski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Pietras
authors.forename: Aneta
authors.initials: A
authors.lastname: Pobudejska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kurylak
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Mankowski
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000473:pathology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011044:Poland; D011878:Radiotherapy; D012189:Retrospective Studies; D013934:Thymectomy; D013953:Thymus Neoplasms / Q000473:pathology* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents