A case of uniportal VATS thymectomy for Thymoma associated with myasthenia gravis and toxic multinodular goiter. (June 2022)

• Record Type: Journal Article
• Authors: Dukmak, Osama N.; Dweik, Ruba; Hashlamoun, Nadeen; Qawasmeh, Rahaf; Al Mohtasib, Mohammad Eid; Asbeh, Yousef Abu
• Is Part Of: International journal of surgery case reports. Volume 95(2022)
• Publication Date: 2022-06
• Subjects: Thymoma -- Myasthenia gravis -- Uniportal VATS -- Toxic multinodular goiter -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.107183
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Background: Thymoma is a rare neoplasm, which may be associated with autoimmune disorders, the occurrence of hyperthyroidism in the patients with thymoma is rare. Clinical presentation: Here we present an extremely rare case of a 56-year-old female patient who was discovered to have malignant thymoma with associated myasthenia gravis and hyperthyroidism due to toxic multinodular goiter. Our patient started to complain of difficulty breathing and swallowing, Chest CT scan was done and revealed an anterior mediastinal mass, measures about 4.1 × 3.1 × 2.2 cm with enlarged lymph node mostly representing thymoma. Complete thymectomy was performed via uniportal video-assisted thoracoscopic surgery, and the patient's postoperative recovery was uneventful. Microscopic histopathology findings corresponded to thymoma type B1. Conclusion: The coexistence of thymoma, MG and toxic multinodular goiter is extremely rare. MG should always be suspected in a patient with thymoma. VATS thymectomy has been increasingly used to treat thymoma as it has several advantages over open surgery. Highlights: It's extremely rare for malignant thymoma to occur with myasthenia gravis and toxic multi-nodular goiter. There is a strong association between Thymoma and myasthenia gravis. VATS surgery for Thymoma has great outcomes. Patients with thymoma and Myasthenia gravis have a worse prognosis than patients with thymoma alone.