P39.04 Thymic Epithelial Tumors: The Importance of Invasive Investigation to Adequate Diagnosis
2021
Introduction: Thymic epithelial tumors (TET) are the most common neoplasms of the anterior mediastinum. The incidence of this disease is extremely low, and there is little data on the Brazilian context. This study aims to describe the experience from PUCRS's Sao Lucas Hospital Thoracic Surgery team on mediastinal tumor resections (MTR) during the investigation of TET. Methods: The Thoracic Surgery team from PUCRS's Sao Lucas Hospital maintains a prospective database with the Brazilian Thoracic Surgery Society. Data from patients who underwent investigation for TET within 2016 and 2020 were collected from medical records in March 2021. Descriptive analyses were performed on this data. We used the classification proposed by the World Health Organization (2004) to classify all cases found. Results: There were 90 MTR performed on a total of 87 patients between 2016 and 2020. Of these, 56 (64.36%) were female, and the average age was 54.28. Among performed MTR, 11 (12.22%) were due to TET, being 10 (11.11%) by thymoma and 1 (1.11%) by thymic carcinoma. From the 10 cases of thymoma, 7 (70%) were female, and the only patient diagnosed with thymic carcinoma was male. Of the 11 patients diagnosed with TET, the average age was 56. According to the TET classification used, 1 (9.09%) was type A, 5 (45.45%) was AB, 1 (9.09%) was B2, 1 (9.09%) was B3, 1 (9.09%) was C (thymic carcinoma was classified as type C), 1 (9.09%) classified as types B1 and B2, and another (9.09%) as types AB and B3. Among 10 cases of thymoma, 2 (20%) had myasthenia gravis (MG). Immediate postoperative mortality was zero. During yearly follow-up, only 1 (9.09%) patient had a recurrence of disease, and 1 (9.09%) died. It is important to highlight that from all 90 MTR performed, 80 (88.88%) occurred between 2016 to 2019 (18 in 2016, 16 in 2017, 21 in 2018, 25 in 2019), resulting in an average of 20 RTM per year. However, in 2020, only 10 (11.11%) RTM were performed, showing a significant reduction during the first year of the COVID-19 pandemic in Brazil. Conclusion: Our data converge to what is shown in the literature since a small portion of patients who underwent MTR had a thymoma diagnosis and only one had a diagnosis of thymic carcinoma. The most frequent type was AB. Studies demonstrate that 30-65% of patients with thymoma also have MG. On the other hand, our sample shows 20%. It is essential to emphasize the reduction in the number of procedures during the Sars-CoV-2 pandemic in 2020. Keywords: thymic carcinoma, thymoma, thoracic malignancies
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