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Intrapericardial Thymoma Presented as Pericardial Tamponade with Post-Operative Myasthenia Gravis

Background: Thymoma is an epithelial mass arising from the thymus. Most thymomas are located in the anterior mediastinum. Ectopic intrapericardial thymoma is very unusual; to date, only eight cases of pericardial thymoma have been reported. Among thymoma patients, 20% to 25% are associated with myas...

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Autores principales: Tsai, Yueh-Hsun, Ko, Kai-Hsiung, Yen, Hao, Huang, Tsai-Wang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147635/
https://www.ncbi.nlm.nih.gov/pubmed/35630026
http://dx.doi.org/10.3390/medicina58050609
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author Tsai, Yueh-Hsun
Ko, Kai-Hsiung
Yen, Hao
Huang, Tsai-Wang
author_facet Tsai, Yueh-Hsun
Ko, Kai-Hsiung
Yen, Hao
Huang, Tsai-Wang
author_sort Tsai, Yueh-Hsun
collection PubMed
description Background: Thymoma is an epithelial mass arising from the thymus. Most thymomas are located in the anterior mediastinum. Ectopic intrapericardial thymoma is very unusual; to date, only eight cases of pericardial thymoma have been reported. Among thymoma patients, 20% to 25% are associated with myasthenia gravis. However, postoperative myasthenia gravis occurs in less than 1% of cases. Here, we share a rare case of ectopic intrapericardial thymoma that developed postoperative myasthenia gravis six months after surgery. Case presentation: A 66-year-old woman visited the outpatient department due to productive cough and chest pain. Chest radiography showed increased soft tissue opacity over the mediastinum. A soft tissue mass in the pericardium and a ground glass nodule in right upper lung were noted using chest computed tomography. The diagnosis of thymoma, type B2, pT3N0M0, and stage IIIA and synchronous adenocarcinoma in situ of the right upper lung was confirmed after surgical removal. Six months later, the patient developed postoperative myasthenia gravis. Conclusions: Thymoma is rarely considered a differential diagnosis in pericardial tumors. Surgical removal with adjuvant radiation therapy should be performed considering the malignancy potential of thymomas and cardiac complications. In patients without myasthenia gravis, a small chance of postoperative myasthenia gravis remains. Patients should be carefully monitored for myasthenia gravis after surgery.
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spelling pubmed-91476352022-05-29 Intrapericardial Thymoma Presented as Pericardial Tamponade with Post-Operative Myasthenia Gravis Tsai, Yueh-Hsun Ko, Kai-Hsiung Yen, Hao Huang, Tsai-Wang Medicina (Kaunas) Case Report Background: Thymoma is an epithelial mass arising from the thymus. Most thymomas are located in the anterior mediastinum. Ectopic intrapericardial thymoma is very unusual; to date, only eight cases of pericardial thymoma have been reported. Among thymoma patients, 20% to 25% are associated with myasthenia gravis. However, postoperative myasthenia gravis occurs in less than 1% of cases. Here, we share a rare case of ectopic intrapericardial thymoma that developed postoperative myasthenia gravis six months after surgery. Case presentation: A 66-year-old woman visited the outpatient department due to productive cough and chest pain. Chest radiography showed increased soft tissue opacity over the mediastinum. A soft tissue mass in the pericardium and a ground glass nodule in right upper lung were noted using chest computed tomography. The diagnosis of thymoma, type B2, pT3N0M0, and stage IIIA and synchronous adenocarcinoma in situ of the right upper lung was confirmed after surgical removal. Six months later, the patient developed postoperative myasthenia gravis. Conclusions: Thymoma is rarely considered a differential diagnosis in pericardial tumors. Surgical removal with adjuvant radiation therapy should be performed considering the malignancy potential of thymomas and cardiac complications. In patients without myasthenia gravis, a small chance of postoperative myasthenia gravis remains. Patients should be carefully monitored for myasthenia gravis after surgery. MDPI 2022-04-27 /pmc/articles/PMC9147635/ /pubmed/35630026 http://dx.doi.org/10.3390/medicina58050609 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Tsai, Yueh-Hsun
Ko, Kai-Hsiung
Yen, Hao
Huang, Tsai-Wang
Intrapericardial Thymoma Presented as Pericardial Tamponade with Post-Operative Myasthenia Gravis
title Intrapericardial Thymoma Presented as Pericardial Tamponade with Post-Operative Myasthenia Gravis
title_full Intrapericardial Thymoma Presented as Pericardial Tamponade with Post-Operative Myasthenia Gravis
title_fullStr Intrapericardial Thymoma Presented as Pericardial Tamponade with Post-Operative Myasthenia Gravis
title_full_unstemmed Intrapericardial Thymoma Presented as Pericardial Tamponade with Post-Operative Myasthenia Gravis
title_short Intrapericardial Thymoma Presented as Pericardial Tamponade with Post-Operative Myasthenia Gravis
title_sort intrapericardial thymoma presented as pericardial tamponade with post-operative myasthenia gravis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147635/
https://www.ncbi.nlm.nih.gov/pubmed/35630026
http://dx.doi.org/10.3390/medicina58050609
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