Management of liver metastases secondary to thymic epithelial tumors: a narrative review of current management and future directions.

BACKGROUND AND OBJECTIVE: Hepatic metastases secondary to thymic epithelial tumors (TETs), encompassing thymomas and thymic carcinomas (TCs), are a rare but clinically meaningful phenomenon and are associated with worse overall survival (OS). Management of liver metastases is largely limited to systemic therapy and chemotherapeutic regimens; although, there are smaller-scale studies in the literature reporting use of more novel treatment regimens and liver-directed therapies. The purpose of this article is to explore management options for TET hepatic metastases, including novel therapeutic options.

METHODS: A review of the available electronic literature was performed through October 10, 2025, using PubMed and Google Scholar. A single author identified the studies, and both authors reviewed the selection to determine which studies to include.

KEY CONTENT AND FINDINGS: The literature involving systemic therapy options was much more developed, as this is the first-line treatment option for TET hepatic metastases. Smaller series supporting the use of surgical resection, radiation therapy, and interventional radiology therapies suggest benefit in liver-directed resection and/or therapies.

CONCLUSIONS: Data evaluating therapeutic options for managing liver metastases secondary to TETs is limited. Given the prognostic implications of these metastatic lesions, a broader understanding of available therapies is essential for determining optimal management.