Recurrent myasthenia gravis due to a pleural implant 3 years after radical thymectomy.
Although recurrence of a thymoma is rare, pleural dissemination or local relapses have been described. We present a patient who underwent complete thymectomy for a thymoma, type AB according to the World Health Organization classification and stage II according to Masaoka, followed by adjuvant radiotherapy. Three years later, a relapse of the myasthenic symptoms occurred. An isolated pleural implant above the left diaphragm was removed by video-assisted thoracoscopy. Pathology confirmed the recurrence of the thymoma. As this is a rare occurrence, no precise therapeutic guidelines exist. In our case, surgical resection of the recurrence with adjuvant immunomodulating therapy for myasthenia provided good results.
Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp, Belgium. stijn_heyman@hotmail.com
Stijn R G
SR
Heyman
Hendrik
H
De Raeve
Rudy
R
Mercelis
Christel
C
De Pooter
Paul
P
Van Schil
D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009157:Myasthenia Gravis / Q000175:diagnosis*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000556:secondary* / Q000601:surgery; D019736:Prostheses and Implants / Q000009:adverse effects*; D012008:Recurrence; D012086:Reoperation; D018570:Risk Assessment; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D013934:Thymectomy / Q000009:adverse effects / Q000379:methods; D013945:Thymoma / Q000556:secondary / Q000601:surgery*; D013953:Thymus Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome