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Vol.60 No.5 contents | Japanese/English |
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- Case Report -
A Case of Post-thymectomy Morvan Syndrome in a Patient with Type B2 Thymoma
Hikaru Watanabe1, Naoki Kanauchi11Department of General Thoracic Surgery, Nihonkai General Hospital, Japan
Background. Morvan syndrome is an autoimmune disease that complicates thymoma. Patient. A 50-year-old man was diagnosed with an anterior mediastinum tumor during periodic visits to the hospital for the treatment of Basedow disease. A thymoma was suspected based on his computed tomography findings. Therefore, thymothymectomy and combined resection of the mediastinal pleura and pericardium were performed. On a pathological examination, although infiltration of the mediastinal pleura was observed, pericardial infiltration was not observed. The pathological diagnosis was thymoma (Masaoka stage II and World Health Organization type B2). Extremity myalgia and convulsions started to appear six months postoperatively, and various tests were performed. The patient tested positive for anti-voltage-gated potassium channel antibodies, and peripheral nerve hyperexcitability was observed on electromyography. In addition, abnormal excitation of the central nervous system, such as delirium and hallucination, was observed. Therefore, Morvan syndrome was diagnosed. After steroid pulse therapy and plasma exchange therapy, treatment with oral steroids was continued. These treatments were successful, and the patient did not experience relapse of Morvan syndrome or thymoma for one and a half years postoperatively. Conclusion. The patient developed Morvan syndrome after thymomectomy, and Morvan syndrome was successfully treated with steroid pulse therapy and plasma exchange therapy. Although Morvan syndrome is a very rare disease, physicians should keep in mind the possibility that it may sometimes develop after thymomectomy.
key words: Morvan syndrome, Thymoma, Voltage-gated potassium channel complex antibodies
Received: March 11, 2020
Accepted: June 15, 2020
JJLC 60 (5): 407-410, 2020
