Download PDF
CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg Rep 2020; 09(01): e33-e36
DOI: 10.1055/s-0040-1714075
Case Report: Thoracic

Myasthenia Gravis Related to Thymic Carcinoma: A Case Study

Daniel Thomas Pereira Lopes 
1   Neurology Departament, Hospital Santa Marcelina, Sao Paulo, São Paulo, Brazil
,
Samila Marissa Pinheiro Gomes
1   Neurology Departament, Hospital Santa Marcelina, Sao Paulo, São Paulo, Brazil
,
Sheila Aparecida Coelho Siqueira
2   Pathology Departament, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
,
Fernando Pereira Frassetto
2   Pathology Departament, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
,
Pedro Henrique Martins Arruda Sampaio
1   Neurology Departament, Hospital Santa Marcelina, Sao Paulo, São Paulo, Brazil
,
Cristiane Araujo Martins Moreno
1   Neurology Departament, Hospital Santa Marcelina, Sao Paulo, São Paulo, Brazil
3   Neurology Departament, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
,
Maria Sheila Guimarães Rocha
1   Neurology Departament, Hospital Santa Marcelina, Sao Paulo, São Paulo, Brazil
4   Neurology Departament, Faculdade Santa Marcelina Curso de Medicina, Sao Paulo, Sao Paulo, Brazil
,
Eduardo Paula Estephan
1   Neurology Departament, Hospital Santa Marcelina, Sao Paulo, São Paulo, Brazil
5   Neurology Departament, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, São Paulo, Brazil
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Myasthenia gravis and thymoma are often presented in association with ∼10% of myasthenic cases having concomitant thymoma. Thymic carcinoma is one of the rarest/aggressive human epithelial tumors and has no correlation with myasthenia gravis hitherto. Here is provided a clinical case and review of literature on a very rare association of thymic carcinoma (with no sign of thymoma) and myasthenia gravis (antiacetylcholine receptor antibody positive). Two years after thymectomy, clinical evolution was satisfactory. This clinical case elicits hypothesis that thymic carcinoma may be related with myasthenia gravis, what may have good prognostic from oncologic and neurologic perspectives.

Keywords

thymus - neurology/neurologic - thoracic surgery - pathology


Publication History

Received: 12 March 2020

Accepted: 06 May 2020

Article published online:
18 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Carr AS, Cardwell CR, Mccarron PO, Mcconville J. A Systematic Review of Population Based Epidemiological Studies in Myasthenia Gravis. Vol 10. 2010 . Available at: http://www.biomedcentral.com/1471-2377/10/46 . Accessed June 16, 2020
    PubMedGoogle Scholar
  • 2 Berrih-Aknin S, Le Panse R. Myasthenia gravis: a comprehensive review of immune dysregulation and etiological mechanisms. J Autoimmun 2014; 52: 90-100
    CrossrefPubMedGoogle Scholar
  • 3 McMacken G, Abicht A, Evangelista T, Spendiff S, Lochmüller H. The increasing genetic and phenotypical diversity of congenital myasthenic syndromes. Neuropediatrics 2017; 48 (04) 294-308
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Abath Neto O, Heise CO, Moreno CA. , et al. Nonlethal CHRNA1-related congenital myasthenic syndrome with a homozygous null mutation. Can J Neurol Sci 2017; 44 (01) 125-127
    CrossrefPubMedGoogle Scholar
  • 5 Sommer N, Harcourt GC, Willcox N, Beeson D, Newsom-Davis J. Acetylcholine receptor-reactive T lymphocytes from healthy subjects and myasthenia gravis patients. Neurology 1991; 41 (08) 1270-1276
    CrossrefPubMedGoogle Scholar
  • 6 Grativvol RS, Silva AM, Guedes BF. , et al. Facial and bulbar muscle atrophy in acetylcholine receptor antibody-positive myasthenia gravis. Arq Neuropsiquiatr 2017; 75 (03) 197-198
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Khan MS, Habib A, Basit I. Unilateral-external ophthalmoplegia: a rare presentation of myasthenia gravis. J Coll Physicians Surg Pak 2016; 26 (11) 142-143
    PubMedGoogle Scholar
  • 8 Kurihara N, Saito H, Nanjo H. , et al. Thymic carcinoma with myasthenia gravis: two case reports. Int J Surg Case Rep 2016; 27: 110-112
    CrossrefPubMedGoogle Scholar
  • 9 Syrios J, Diamantis N, Fergadis E. , et al. Advances in thymic carcinoma diagnosis and treatment: a review of literature. Med Oncol 2014; 31 (07) 44 . Doi: 10.1007/s12032-014-0044-2
    CrossrefPubMedGoogle Scholar
  • 10 Li W, Miao Z, Liu X. , et al. Thymic carcinoma patients with myasthenia gravis exhibit better prognoses. Int J Clin Oncol 2016; 21 (01) 75-80
    CrossrefPubMedGoogle Scholar
  • 11 Nakajima J, Okumura M, Yano M. , et al; Japanese Association for Research of Thymus. Myasthenia gravis with thymic epithelial tumour: a retrospective analysis of a Japanese database. Eur J Cardiothorac Surg 2016; 49 (05) 1510-1515
    CrossrefPubMedGoogle Scholar
  • 12 Kim SH, Koh IS, Minn YK. Pathologic finding of thymic carcinoma accompanied by myasthenia gravis. J Clin Neurol 2015; 11 (04) 372-375
    CrossrefPubMedGoogle Scholar
  • 13 Kondo K. Tumor-node metastasis staging system for thymic epithelial tumors. J Thorac Oncol 2010; 5 (10) (Suppl. 04) S352-S356
    CrossrefPubMedGoogle Scholar
  • 14 Schluep M, Willcox N, Vincent A, Dhoot GK, Newsom-Davis J. Acetylcholine receptors in human thymic myoid cells in situ: an immunohistological study. Ann Neurol 1987; 22 (02) 212-222
    CrossrefPubMedGoogle Scholar
  • 15 Marx A, Willcox N, Leite MI. , et al. Thymoma and paraneoplastic myasthenia gravis. Autoimmunity 2010; 43 (5-6): 413-427
    CrossrefPubMedGoogle Scholar