Surgery is the mainstay of treatment of thymoma.

• Surgery is the mainstay of treatment of thymoma.
• If the tumor is grossly invasive and large, preoperative (neoadjuvant) chemotherapy and/or radiotherapy may be used to decrease the size and improve resectability, before surgery is attempted.
• When the tumor is at an early stage (Masaoka I through IIB), no further therapy is necessary.
• Malignant tumors may need additional treatment with radiotherapy, or sometimes with chemotherapy, such as cyclophosphamide, doxorubicin, and cisplatin.^[1]
• Complete resection may require resection of the adjacent structures, including pleura, lungs, pericardium, phrenic nerves, and sometimes major vascular structures.
• Pleural surfaces should be examined for metastasis.
• There is no long term data to support minimally invasive procedures.^[2]
• A full median sternotomy is the standard open approach.
• The mediastinum must be explored for cervical thymus extension.

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