COVID-19 in patients with thymic epithelial tumors with or without Good's syndrome: a single-center retrospective study.

INTRODUCTION: Thymic epithelial tumors (TETs) are rare neoplasms often associated with immune-related disorders. Patients with Good's syndrome (GS), an adult-acquired TET-related immunodeficiency, are at a high risk of mortality due to infectious diseases. This study aims to examine COVID-19 occurrence and severity in TET patients, with or without GS. METHODS: Clinical records of TET patients referred to the Regional Coordinating Center for Rare Tumors of Campania Region were retrospectively collected. During the observation period, elapsing from March 2020 to April 2023, the following data were collected: occurrence of SARS-CoV-2 infection; COVID-19 severity, according to the National Institute of Health (NIH) illness categories; COVID-19 treatment. COVID-19 occurrence and severity were assessed in the overall population and correlated with the presence of GS and/or other immune-related dysregulations. RESULTS: Overall, 47 TET patients were included in the study; 27 of these (57.4%) had GS. All participants had received a full cycle of mRNA vaccine for SARS-CoV2., Thirty-one patients (66.0%) experienced COVID-19, of whom 18 (58.0%) had previously received a diagnosis of GS. No significant association of GS and/or other immune-related dysregulations with SARS-CoV-2 infection occurrence was detected (Fisher's exact test p = 1 and p = 0.3587, respectively). Among patients with GS, 8 (45.0%) reported a COVID-19 severity score of ≥ 3; whereas, only 1 of the 13 patients without GS (7.7%) had a severity score of ≥ 3. The correlation between presence of GS and COVID-19 severity (score 1 or 2 vs. ≥ 3) was statistically significant (p = 0.0448). No statistically significant association between COVID-19 severity and other immune-related syndromes were found (p = 1). Of note, all the hospitalized patients for NIH 4 and 5 COVID-19 had GS. CONCLUSIONS: Our data suggest that TET patients, especially those with GS, require a careful multidisciplinary monitoring for SARS-CoV-2 infection, in order to establish tailored treatments and prophylactic protocols.

Incidence of second malignancies in patients with thymic carcinoma and thymic neuroendocrine tumor.

OBJECTIVES: Thymic carcinoma and thymic neuroendocrine tumor (NET) are rare and are more likely to develop second malignancies. The purpose of this study was to explore the incidence and lifetime risk of second malignancies in thymic carcinoma and thymic NET. METHODS: The standardized incidence ratio (SIR) and the age-adjusted cancer incidence of the thymic carcinoma and thymic NET patients with second malignancies were retrospectively calculated by using the Surveillance, Epidemiology, and End Results (SEER) database. Prognosis results were also determined by Kaplan-Meier analysis and Cox regression. RESULTS: 1130 patients with thymic carcinoma (73 patients had second malignancies) and 263 patients with thymic NET (19 patients had second malignancies) from 2000 to 2018 are included. Patients with thymic carcinoma (SIR: 1.36, 95% CI 1.08-1.69) and with thymic NET (SIR: 1.73, 95% CI 1.13-2.54) demonstrate an increased overall risk of developing second malignancies in various organ systems. The age-adjusted cancer incidence of second malignancies in patients with thymic carcinoma is 3058.48 per 100,000 persons (4178.46 per 100,000 persons in patients with thymic NET). Age at diagnosis is a significant risk factor for the development of second malignancies. CONCLUSION: The incidence of second malignancies in patients with thymic carcinoma and thymic NET is significantly higher than the patients in the normal population. The occurrence of second malignancies is not related to the use of different treatments. It is important to extend the follow-up period and add other screening methods.

Tumores del mediastino: resultados de una encuesta argentina sobre 1039 casos / Mediastinal tumors: results of argentine survey with 1039 cases

Un total de 1039 tumores del mediastino se recopilaron de 12 Servicios, correspondieron a: timo 353 (34 por ciento), neurogénico 178 (17,2 por ciento), quistes 144 (13,9 por ciento), linfoma de mediastino 115 (11 por ciento), germinal 87 (8,4 por ciento), mesenquimático 63 (6,0 por ciento), endocrino 27 (2,6 por ciento) y varios 72 (6,9 por ciento). El 53,5 por ciento se ubicaron en mediastino anterior, el 39 por ciento fueron asintomáticos y 57 por ciento benignos o no invasores. Como método diagnóstico invasor la punción percutánea fue utilizada por 10 centros, 7 solamente ante tumores invasores, siendo los resultados buenos o muy buenos en 7. Ocho centros utilizaron mediastinoscopia, 12 mediastinotomía y 6 videotoracoscopia. La esternostomía mediana fue la vía de abordaje electiva en los tumores anteriores, y la toracotomía posterolateral en los tumores medios y posteriores. La videotoracoscopia terapéutica fue utilizada selectivamente en 9 centros, básicamente ante quistes y tumores benignos (< 6 cm). El timoma fue el tumor más frecuente del timo (327 casos); 10 centros adoptan la división en timoma no invasor-invasor utilizando la clasificación clínica de Masaoka. En 11 centros realizan solamente resección quirúrgica ante el timoma Estadio I, en todos tratamiento adyuvante en el estadio II y III. En 64/115 linfomas la variedad correspondió al Hodgkin. Ciento cuarenta y tres tumores neurogénicos fueron benignos (80,3 por ciento), el neurofibroma y neurolemona los más frecuentes. El 51,7 por ciento de los tumores germinales fueron malignos (45 casos), prevaleciendo entre ellos el seminoma y teratoma maduro. De 144 quistes, 63 fueron broncogénicos, hallándose 9 quistes hidatídicos. Las formas benignas y malignas de los mesenquimáticos se presentaron con igual frecuencia, el lipoma fue el tumor más frecuente. Se presentaron 23 bocios endotorácicos y 4 tumores paratiroideos