title: [Thymoma Associated with Pure Red Cell Aplasia Treated with Ciclosporin as Remission-induction Therapy before Thymectomy].
abstract: A thymoma with pure red cell aplasia( PRCA) is relatively rare, and the treatment of the disease has not established yet. We describe a case of a thymoma associated with PRCA treated with a surgery and remission-induction therapy by ciclosporin. An 80-year-old man complained of dizziness and his blood cell count showed a severe anemia. He was diagnosed as PRCA by bone-marrow aspiration biopsy, which showed abatement of erythroblasts. In addition, the chest computed tomography revealed a solid tumor in the anterior mediastinum, strongly suggesting a thymoma. Oral administration of ciclosporin as remission-induction therapy for PRCA was started at 1st. The treatment contributed to partial remission for PRCA without blood transfusion. Consecutively thymectomy through median sternotomy was performed at 6 weeks after initiation of the treatment without any transfusions or complications. Histology of the solid tumor showed the thymoma of type B2 in World Health Organization (WHO) category. We continued to treat PRCA with ciclosporin after the surgery. The patient has been surviving for 2 years after surgery without any recurrence of thymoma or relapse of anemia. Combined therapy of surgery and remission-induction therapy with ciclosporin assumed to be a good strategy of the treatment for the patient with a thymoma associated with PRCA.
authors.affiliation: Department of Thoracic Surgery, Iwate Prefectural Central Hospital, Morioka, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kawakami
authors.forename: Itaru
authors.initials: I
authors.lastname: Ishida
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Yoshimura
authors.forename: Takafumi
authors.initials: T
authors.lastname: Sugawara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Oura
authors.forename: Yasuro
authors.initials: Y
authors.lastname: Miyairi
mesh_terms: D000369:Aged, 80 and over; D001706:Biopsy; D016572:Cyclosporine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D012010:Red-Cell Aplasia, Pure / Q000209:etiology*; D012074:Remission Induction; D013934:Thymectomy; D013945:Thymoma / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D013953:Thymus Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*
chemical_list: D016572:Cyclosporine