PO196 Late-onset myasthenia gravis and carcinoid tumour. (1st December 2017)

• Record Type: Journal Article
• Authors: Fratalia, Lauren; Larner, Andrew
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 88(2017)Supplement 1
• Page Start: A63
• Page End: A63
• Publication Date: 2017-12-01
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2017-ABN.217
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objective: To report a patient with late-onset seropositive myasthenia gravis in whom further investigations disclosed a carcinoid tumour, a rarely reported association. Results: An 83-year-old woman presented with a six-month history of double vision, drooping of her right eyelid, and dysphagia. Similar symptoms had occurred two years previously but remitted spontaneously after a few weeks. Acetylcholine receptor antibody assay was strongly positive, confirming the clinical diagnosis of myasthenia gravis. Symptomatic treatment with pyridostigmine and then disease-modifying therapy with intravenous immunoglobulin produced clinical benefit. Computed tomography of the thorax showed a lobulated soft tissue mass (2.8 × 4.0 cm) lying in the anterior mediastinum adjacent to the right heart border. Transthoracic biopsy of this lesion showed features of a carcinoid tumour. Conclusion: Carcinoid tumours have rarely been reported in association with myasthenia gravis: we have identified only two previously reported cases (one from Liverpool). It remains unclear whether this represents a chance concurrence of two rare disorders or a paraneoplastic phenomenon.