Late-onset myasthenia gravis successfully treated with local resection of cervical ectopic thymoma. (March 2020)

• Record Type: Journal Article
• Authors: Sekiguchi, Teruhiko; Yoshida, Ken; Minamihara, Yukina; Hayashi, Hiroki; Oka, Teruaki; Orimo, Satoshi
• Is Part Of: Journal of clinical neuroscience. Volume 73(2020)
• Page Start: 321
• Page End: 323
• Publication Date: 2020-03
• Subjects: Generalized myasthenia gravis -- Thymectomy -- Acetylcholine receptor antibody -- Elderly -- Local resection -- Guideline; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2019.12.055
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Ectopic cervical thymoma (ECT) may rarely be detected in myasthenia gravis (MG) patients. Guidelines recommend extended thymectomy for MG patients with thymoma. Whether to perform extended thymectomy in MG with ECT still remains unclear. Transcervical local resection of ECT may be effective in elderly or multimorbid MG patients. Abstract: A 78-year-old woman was admitted complaining progressive respiratory failure, neck weakness and gait disturbance. She was diagnosed as acetylcholine receptor antibody-positive myasthenia gravis crisis with ectopic cervical thymoma. After she recovered from crisis by plasmapheresis and administration of prednisone, we did not choose extended thymectomy but chose local resection of ectopic thymoma considering her age and complications. After the operation, she got minimal manifestations and no relapse of thymoma. Although international and Japanese guidelines recommend extended thymectomy for myasthenia gravis with thymoma, isolated local resection of ectopic thymoma may be enough for controlling myasthenia gravis especially in elderly patients.