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Vol.54 No.2 contents | Japanese/English |
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- Case Report -
A Case of Post-thymectomy Myasthenia Gravis in a Patient with Type B3 Thymoma
Mariko Fukui1, Kazuya Takamochi1, Yoshitaka Kitamura1, Siaki Oh1, Takuo Hayashi2, Kenji Suzuki11Department of Thoracic Surgery, 2Department of Pathology, Juntendo University School of Medicine, Japan
Objectives. Myasthenia gravis occasionally develops after thymectomy, even in asymptomatic patients. This condition is termed post-thymectomy myasthenia gravis. Case. A 70-year-old male underwent thymectomy combined with resection of a tumor in the anterior mediastinum that extended to the superior vena cava. A preoperative needle biopsy and intraoperative frozen section revealed the existence of thymic carcinoma. Although the patient was asymptomatic, the titer of anti-acetylcholine receptor antibodies was elevated. He was discharged on the 14th day after surgery. Twenty days after the operation, the patient complained of breathing difficulties in the supine position. He visited our outpatient clinic and was admitted to the hospital for a further detailed examination. He suddenly suffered cardiopulmonary arrest at midnight on the 22nd day after surgery, and, after resuscitation, was treated with a mechanical ventilator. His symptoms abated following the administration of steroid and immunosuppressive therapy. A detailed examination revealed a diagnosis of post-thymectomy myasthenia gravis. The final pathological diagnosis was revised to WHO-classification type B3 thymoma based on the histological findings of the surgical specimen. Conclusions. Special attention should be paid to the potential for post-thymectomy myasthenia gravis, especially in patients with an elevated preoperative anti-acetylcholine receptor antibody level, even those who are asymptomatic.
key words: Post-thymectomy myasthenia gravis, Postural hypoxia, Thymoma type B3
Received: July 15, 2013
Accepted: February 12, 2014
JJLC 54 (2): 52-56, 2014
