Thymic carcinoma is a thymic epithelial tumour with a high degree of anaplasia, cell atypia and increased proliferation and predominantly occurs in adults. Thymic carcinomas have a poor prognosis despite treatment with surgery and radiotherapy. Thymic carcinomas are aggressive, locally invasive malignancies that have frequently metastasised to regional lymph nodes and distant sites at presentation. They are typically large, heterogeneous masses, containing areas of necrosis and calcification, often demonstrating evidence of invasion of adjacent structures, in particular the mediastinum, pericardium and pleura (Fig. 1). On MR, thymic carcinoma demonstrates intermediate signal intensity slightly higher than muscle on T1-weighted sequence and high signal intensity on T2-weighted sequence. Thymic carcinomas are more commonly associated with mediastinal node and extrathoracic metastasis but less commonly associated with pleural implants compared with invasive thymomas.
FIGURE 1 ■ Thymic carcinoma. A 16-year-old man with history of weight loss and night sweats. Contrast medium-enhanced CT images show a heterogeneously enhancing anterior mediastinal mass arising from the right lobe of the thymus (A), with cystic (or necrotic) components. It extends inferiorly in the retrosternal space (B) and has no clear fat plane between it and the mediastinal structures (B). It was surgically excised and pathological examination revealed thymic carcinoma.
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