Thymic carcinoma with myasthenia gravis: Two case reports

Kurihara, Nobuyasu; Saito, Hajime; Nanjo, Hiroshi; Konno, Hayato; Atari, Maiko; Saito, Yasutoshi; Fujishima, Satoshi; Kameyama, Komei; Minamiya, Yoshihiro

doi:10.1016/j.ijscr.2016.08.010

Cited by 7 publications

(6 citation statements)

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“…One possible pathogenic mechanism is the development of TC inside a thymoma, with the remaining lymphoid cells being responsible for inducing antibody production, in a manner similar that of pure thymomas. When it arises from a thymoma, develops in the necrotic tissue 8 , more frequently inside a type B3 thymoma. 12 …”

Section: Discussionmentioning

confidence: 99%

“…Although the role of autoimmunity in thymoma is not totally clear, it is known that thymic cells exported to the periphery may include undeleted autoreactive T cells with deficient molecular components important for tolerance. 5 Thymic carcinoma (TC), however, is a malignant epithelial tumor with cytologic atypia, without any thymus-like features; this is one reason why it is not, in theory, expected to accompany MG. 8 TC is among the rarest human neoplasms (constituting only 5% of all thymic neoplasms 9 ), and is characterized by its aggressiveness and poor prognosis (5-year survival rate, 15-65% 10 ), due to its invasiveness and metastasizing potential. Histological features of this tumor are anaplasia, cell atypia, paucity of lymphocytes and increased proliferation, enlarged nuclei, coarse chromatin, discrete macronucleoli and a moderate amount of cytoplasm.…”

Section: Introductionmentioning

confidence: 99%

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Myasthenia Gravis Related to Thymic Carcinoma: A Case Study

Lopes

Gomes

Siqueira

et al. 2020

Thorac Cardiovasc Surg Rep

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Myasthenia gravis and thymoma are often presented in association with ∼10% of myasthenic cases having concomitant thymoma. Thymic carcinoma is one of the rarest/aggressive human epithelial tumors and has no correlation with myasthenia gravis hitherto. Here is provided a clinical case and review of literature on a very rare association of thymic carcinoma (with no sign of thymoma) and myasthenia gravis (antiacetylcholine receptor antibody positive). Two years after thymectomy, clinical evolution was satisfactory. This clinical case elicits hypothesis that thymic carcinoma may be related with myasthenia gravis, what may have good prognostic from oncologic and neurologic perspectives.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Myasthenia Gravis Related to Thymic Carcinoma: A Case Study

Lopes

Gomes

Siqueira

et al. 2020

Thorac Cardiovasc Surg Rep

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“…A thyroid mass should be seen in continuity with the normal thyroid gland. In contrast, a normal appearing native thyroid gland is often seen separate in patients with a thymoma [31].…”

Section: Thyroid Masses With Mediastinal Extensionmentioning

confidence: 98%

“…On CT, thymoma is seen as rounded or lobulated, homogenous, soft tissue mass in the anterior mediastinum anywhere from suprasternal notch up to the diaphragm [31]. Drop metastases to the pleura are known to show similar imaging and contrast features [31]. On MR, it shows iso-low T1, intermediate T2 signal intensity with variable, typically mild, contrast enhancement [32].…”

Section: Clinical and Imaging Findingsmentioning

confidence: 99%

Co-existent Epicardial Paraganglioma and Anterior Mediastinal Thymoma

et al. 2020

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Thymoma and paraganglioma are known causes of mediastinal masses, the latter being extremely rare. Thymomas arise from remnant thymic tissue in the anterior mediastinum; whereas, thoracic paragangliomas arise from paraaortic or para-vertebral sympathetic chain ganglion (derivatives of embryonic neural crest) in the middle or posterior mediastinum. We report a case of a middle-aged woman with two mediastinal masses, originally believed to be a single tumor or primary malignancy with adjacent metastasis on Computed Tomography (CT) that were further delineated with Magnetic Resonance Imaging (MRI) and [68Ga]-DOTA-(Tyr3)-octreotate (DOTA-TATE) Positron Emission Tomography-Computed Tomography (PET-CT) and surgical pathology as two distinct entities: left epicardial paraganglioma and anterior mediastinal thymoma. A comprehensive discussion of both entities is included. CASE REPORTA 58-year-old woman presented to an outside hospital via emergency medical services for crushing chest pain and was found to have one millimeter ST-segment elevation in leads II, III, AVF and V5-V6. She was taken for emergent cardiac catheterization with the working diagnosis of inferior wall myocardial infarction. During cardiac catheterization, no evidence of coronary artery disease was found. However, a large, highly vascularized mass along the anterior basal wall of the left ventricle was observed under fluoroscopy. Blood supply to the mass was seen originating from both coronary arteries, but predominantly from the left anterior descending coronary artery (Figure 1a, 1b).Computed Tomography Angiogram (CTA) of the Chest was then obtained for better anatomical delineation of the mass. CTA revealed a large mass within the pericardium that was located along the anterior left atrioventricular groove extending superiorly up to the level of pulmonary trunk and

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“…Thymoma is associated with autoimmune-related syndromes including myasthenia gravis (MG), pure erythrocyte hypoplasia, and hypogammaglobulinemia ( 1 , 2 ). The 5-year survival rates for thymomas and TCs have been reported to be approximately 78% and 40%, respectively ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

The Studies of Prognostic Factors and the Genetic Polymorphism of Methylenetetrahydrofolate Reductase C667T in Thymic Epithelial Tumors

Yan

Xue

et al. 2022

Front. Oncol.

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ObjectiveTo describe the clinical features of a cohort of patients with thymic epithelial tumors (TETs) and to analyze their prognostic factors. In particular, we investigated the correlation between the genetic polymorphism of methylenetetrahydrofolate reductase (MTHFR) C667T and the incidence of TETs.MethodsPathological records were reviewed from the database of the Second Affiliated Hospital of Jiaxing University, from January 2010 to December 2020, and 84 patients with TETs were recruited for this study. Univariate and multivariate analyses were performed to determine the prognostic factors. The genetic polymorphism of MTHFR C667T was examined in the patients with TETs and in a group of healthy individuals. The correlation between MTHFR transcriptional levels and methylation was analyzed using The Cancer Genome Atlas (TCGA) thymoma dataset from the cBioPortal platform.ResultsKaplan–Meier univariate survival analysis showed that sex, age, the maximum tumor diameter, surgery, chemotherapy, radiotherapy, WHO histological classification, Masaoka–Koga stage, and 8th UICC/AJCC TNM staging, were statistically significantly correlated with the prognosis of patients with TETs. The Masaoka–Koga stage and 8th UICC/AJCC TNM staging were strongly correlated with each other in this study (r=0.925, P<0.001). Cox multivariate survival analysis showed that the maximum tumor diameter, Masaoka–Koga stage, and 8th UICC/AJCC TNM staging were independent prognostic factors affecting the overall survival (OS) of patients with TETs (P<0.05). The MTHFR C667T genotype (χ2 = 7.987, P=0.018) and allele distribution (χ2 = 5.750, P=0.016) were significantly different between the patients and healthy controls. CT heterozygous and TT homozygous genotypes at this MTHFR polymorphism significantly increased the risk of TETs (odds ratio [OR] =4.721, P=0.008). Kaplan–Meier univariate survival analysis showed that there was no correlation between different genotypes and the prognosis of TETs (CC versus CT + TT, χ2 =0.003, P=0.959). Finally, a negative correlation between the transcriptional and methylation levels of MTHFR was observed in the TCGA thymoma dataset (r=-0.24, P=0.010).ConclusionsThe Masaoka–Koga stage, 8th UICC/AJCC TNM staging, and maximum tumor diameter were independent prognostic factors for TETs. Reduced methylation levels of MTHFR and particular polymorphic variants may contribute to the susceptibility to developing TETs.

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Thymic carcinoma with myasthenia gravis: Two case reports

Abstract: HighlightsMyasthenia gravis (MG) has been reported to correlate with earlier-stage thymoma and theoretically does not accompany thymic carcinoma.We encountered two cases of thymic carcinoma with MG.Very few reports have described MG associated with thymic carcinoma.

Cited by 7 publications

References 11 publications

Myasthenia Gravis Related to Thymic Carcinoma: A Case Study

Myasthenia Gravis Related to Thymic Carcinoma: A Case Study

Co-existent Epicardial Paraganglioma and Anterior Mediastinal Thymoma

The Studies of Prognostic Factors and the Genetic Polymorphism of Methylenetetrahydrofolate Reductase C667T in Thymic Epithelial Tumors

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