Unusual clinical behaviour of thymoma with recurrent myasthenia gravis

Interact Cardiovasc Thorac Surg. 2012 Jun;14(6):909-11. doi: 10.1093/icvts/ivs064. Epub 2012 Feb 28.

Abstract

A 58-year old man with thymoma and myasthenia gravis (MG) had undergone thymectomy 8 years ago with histopathologically confirmed non-invasive WHO-type AB thymoma. After 5 years of complete remission, symptoms of MG resurfaced, and a recurrent anterior mediastinal mass was detected for which he received radiotherapy. He presented to us 3 years later with productive cough and exertional dyspnoea; the positron emission tomography-computed tomography scan revealed a metabolically active pulmonary nodule in the right lung as the only site of disease for which a right lower lobectomy was done. Microscopy established an intrapulmonary WHO-type B2 thymoma and the patient is currently asymptomatic on steroids, anticholinesterase and immunosuppressant therapy. We discuss the variable and unpredictable course of thymomas; the possibility of transformation into more aggressive types with each recurrence, association with recurrent MG post-thymectomy and presentation several years later with metastatic disease.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / analysis
  • Biopsy
  • Humans
  • Immunohistochemistry
  • Lung Neoplasms / chemistry
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Myasthenia Gravis / complications*
  • Myasthenia Gravis / diagnosis
  • Myasthenia Gravis / therapy
  • Neoplasm Recurrence, Local*
  • Pneumonectomy
  • Positron-Emission Tomography
  • Recurrence
  • Reoperation
  • Solitary Pulmonary Nodule / chemistry
  • Solitary Pulmonary Nodule / secondary*
  • Solitary Pulmonary Nodule / surgery
  • Thymectomy
  • Thymoma / chemistry
  • Thymoma / secondary*
  • Thymoma / surgery
  • Thymus Neoplasms / chemistry
  • Thymus Neoplasms / pathology*
  • Thymus Neoplasms / surgery
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Biomarkers, Tumor