1995 Volume 9 Issue 2 Pages 205-211
Myasthenia gravis and pure red cell aplasia developed in a 44-year-old female three months after thymectomy for invasive thymoma. Her chest X-ray had demonstrated a mass on the left diaphragm. Preoperative examinations revealed neither myasthenia gravis nor anemia. Percutaneous biopsy indicated thymoma invading the thoracic cavity, and thymectomy as well as tumor extirpation was attempted through a median sternotomy. The thymoma had invaded the upper lobe of the lung, and there were many metastatic lesions 5 to 10 mm in diameter, mainly on the parietal pleura, and a fist-sized tumor adherent to the diaphragm. These tumors were resected along with the thymus and the parathymic adipose tissue. The tumor consisted predominantly of small lymphocytes and epithelial cells. The pathological diagonosis was invasive thymoma, stage IVa. To prevent recurrence, the patient received anticancer drugs intermittently through a subcutaneous implantable reservoir (PORT A CATH) bimonthly. About three months after the operation, the patient complained of general malaise and diplopia. These symptoms were attributed to myasthenia gravis and pure red cell aplasia. Her myasthenia and anemia were marked reduced by steroid therapy. She is now living and well with no evidence of recurrence of the diseases.
