Diagnosis and management of thymomas in the Covid-19era

ABSTRACT

Introduction and Aims: Thymoma is a rare but the commonest primary malignancy of the anterior mediastinum(35%), with an annual incidence around 3 per million population (Girard et al. Annals of Oncology 2015;26v40-55).Standard first line imaging is CT thorax with contrast. During the Covid-19 era more CTs were performed. Weevaluated whether this affected the diagnosis and management of thymomas in a UK district general hospital. Method(s) We included CT scan reports from 1 January 2019 to 31 December 2021 with the terms 'thymoma','thymic' and 'thymus' (n=171). Non-diagnoses and existing diagnoses of thymomas were excluded. Data wascollected on patient demographics, presenting symptoms, scan circumstances, size of mass, further investigationsand staging. Result(s) We identified 21 potential diagnoses of thymoma, ages ranging from 14 to 89 years. Half were male and71% Caucasian. Commonest presenting symptoms were shortness of breath and cough (33%). 3 scans wereperformed as part of Covid management. 7 patients underwent a biopsy, of whom 4 had histology-confirmedthymoma (Table 1). Discussion(s) Results highlight that despite frequent mentions of mediastinal abnormalities in CT reports, few are investigated. Only 57% of those biopsied were diagnosed with thymoma, likely representing underdiagnosis. In addition, the increased number of CTs performed during the Covid pandemic did not result in more diagnoses of thymoma.