- Rapid improvement of muscle weakness post-thymectomy indicates good long-term neurological outcome in patients with ocular myasthenia gravis. [Journal Article]
- EJEur J Neurol 2019 Jul 12
- CONCLUSIONS: Postoperative rapid remission of MG status predicts a higher likelihood of complete remission in patients with oMG. This article is protected by copyright. All rights reserved.
- Thymoma-Associated Paraneoplastic Autoimmune Multiorgan Syndrome-From Pemphigus to Lichenoid Dermatitis. [Case Reports]
- FIFront Immunol 2019; 10:1413
- CONCLUSIONS: In the present case, thymoma was the cause of the observed multi-organ autoimmune syndromes as its recurrence and surgical removal was associated with the relapse and regression of the cutaneous symptoms, respectively. Initially, the patient presented with two autoimmune disorders with Th2/Th1 imbalance, myasthenia gravis (MG) and pemphigus foliaceus (PF), which regressed upon immunosuppressive treatment. Months later, the patient developed a lichenoid exanthema with a Th1-dominated skin infiltrate. Further clinical evaluation revealed the recurrence of the thymoma and the lichenoid exanthema gradually regressed upon thymectomy. Our contention that T cell recognition against distinct cutaneous autoantigens, such as desmoglein 1 (Dsg1), shifted from a Th2 to a Th1-dominated immune response could not be fully substantiated as the patient was on a stringent immunosuppressive treatment regimen. We could only observe a decrease of the initially present serum IgG autoantibodies against Dsg1. Phenotypic analysis of the associated thymoma showed a lower number of T regulatory cells compared to adult thymus and indolent thymoma, suggesting that impaired thymus-derived immune surveillance had a direct impact on the outcome of the observed cutaneous autoimmune disorders.
- Subxiphoid Robot-assisted Thymectomy with Vascular Prosthetic Replacement. [Journal Article]
- STSemin Thorac Cardiovasc Surg 2019 Jul 03
- Robotic resection of a thymoma behind the left innominate vein. [Journal Article]
- ICInteract Cardiovasc Thorac Surg 2019 Jul 04
- Anatomical variations of one or both thymic upper poles located behind the left innominate vein (LIV) are found in some patients; however, minimally invasive dissection of ectopic thymic tissues behi…
Anatomical variations of one or both thymic upper poles located behind the left innominate vein (LIV) are found in some patients; however, minimally invasive dissection of ectopic thymic tissues behind the LIV is technically complex. We described a case of a dumbbell-shaped thymoma behind the LIV. The patient was successfully treated with trans-subxiphoid robot-assisted thoracoscopic extended thymectomy. Both the LIV and tumour capsule were preserved intact. In our opinion, robotic surgery might expand the indications for minimally invasive thymectomy. It can be applied in selected difficult cases and sternotomy can be avoided in some situations.
- [Synchronous Multicentric Thymoma]. [Case Reports]
- KGKyobu Geka 2019; 72(6):442-445
- A 76-year-old man was referred to our hospital because of an abnormal shadow on chest X-ray. His physical exams and laboratory data were not notable. Chest computed tomography (CT) showed 2 nodular l…
A 76-year-old man was referred to our hospital because of an abnormal shadow on chest X-ray. His physical exams and laboratory data were not notable. Chest computed tomography (CT) showed 2 nodular lesions with clear margin in anterior mediastinum. The nodule at the left inferior pole of the thymus was 9 cm in diameter, and another one at the right inferior pole was 3.5 cm in diameter. We performed thymo-thymectomy by median sternotomy. Histological study revealed that the left tumor was type B2 thymoma and the other one was type A thymoma. Both were completely encapsulated without invasion, which means stage Ⅰ by Masaoka's classification. The patient has showed no evidence of recurrence for 11 years following the surgery. This is the 1st case in Japan that reported synchronous multicentric thymoma with apparently different histology of type A and B2.
- Good's syndrome, a rare form of acquired immunodeficiency associated with thymomas. [Journal Article]
- CPClin Pract 2019 May 06; 9(2):1112
- Good's syndrome (GS) or thymomaassociated immunodeficiency is a rare clinical entity that should be ruled out in patients with thymoma who develop severe, recurrent bacterial infections and opportuni…
Good's syndrome (GS) or thymomaassociated immunodeficiency is a rare clinical entity that should be ruled out in patients with thymoma who develop severe, recurrent bacterial infections and opportunistic viral and fungal infections. There are no treatment protocols established, hence, early recognition is imperative to avoid complications. We report the case of a 42-year-old female, known for a previous thymectomy for giant thymoma who has suffered for a long time from recurrent pulmonary and urinary tract infections and cold sores. In March 2016 she referred to our unit complaining of fever, cough, chest pain, and cold sores due to Herpes simplex virus (HSV), confirmed serologically as HSV-1. Chest X-ray showed left pneumonia due to Streptococcus pneumoniae. She started antibiotics (amoxicillin/clavulanic acid associated with azithromycin) with gradual improvement. Given her history she was studied for an underlying immunodeficiency: IgG, IgA, and IgM were significantly low or absent, as well as all IgG subclasses; blood and bone marrow aspirate leucocyte immunophenotyping showed complete absence of B lymphocytes and reduced CD4+ T cells. In light of: i) thymoma; ii) B lymphocyte deficit; iii) hypogammaglobulinemia; iv) recurrent infections, GS was diagnosed and pre-emptive immunoglobulin treatment, associated with HSV and Pneumocystis jiroveci prophylaxis (Acyclovir for HSV and Sulfamethoxazole- Trimethoprim for P. jiroveci) were started. Since then the patient has no longer presented any infectious episodes.
- Opioid free postoperatively using Pecto-Intercostal Fascial Block (PIFB) with multimodal Analgesia (MMA) in a patient with myasthenia gravis underwent thymectomy via sternotomy. [Letter]
- JCJ Clin Anesth 2019 Jun 11; 59:32-33
- Anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor GluR2 encephalitis in a myasthenia gravis patient with complete thymectomy: a case report. [Journal Article]
- BNBMC Neurol 2019 Jun 13; 19(1):126
- CONCLUSIONS: Thymoma was reported to be associated with paraneoplastic neurological disease. This is the first time a thymectomy has been applied in a myasthenia gravis patient with thymoma two years prior to the onset of anti-AMPAR2 encephalitis. This case highlights the complexity of autoimmune encephalitis associated with thymoma.
- Thoracoscopic thymectomy - The method of choise in surgical treatment of non-invasive thymomas. [Journal Article]
- AMAnn Med Surg (Lond) 2019; 42:29-34
- CONCLUSIONS: Thoracoscopic thymectomy in comparison with thymectomy from open surgical approach contributes to a significant decrease in the length of patients' stay in the intensive care unit and hospital, and the duration of analgesia with narcotic analgesics in the postoperative period. All of the above factors contribute to shorter periods of functional recovery of patients and a full return to a normal lifestyle.
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- Early extubation after thymectomy is good for the patients with myasthenia gravis. [Journal Article]
- NSNeurol Sci 2019 Jun 10
- CONCLUSIONS: Our analysis of patients with MG who received thymectomy procedures indicated that early extubation was associated with improved clinical outcomes, in particular with reduced risk of postoperative pulmonary infection and reduced ICU stay.