Objective: To report a rare syndrome associated with a thymoma and its first successful treatment with gammaglobulin.
Clinical features: A 49-year-old white male presented with marked hypothermia, hyperhidrosis, myokymia and increased urinary excretion of catecholamines four weeks after complete excision of a malignant thymoma. He became increasingly drowsy, obtunded and required ventilatory support.
Intervention and outcome: A catecholamine secreting tumour was excluded and he was treated with intravenous gammaglobulin for five days, with dramatic improvement in his condition. Six months later he remains in remission.
Conclusion: The response to treatment in this patient suggests an immunological pathogenesis for this rare group of symptoms associated with a thymoma.