Rationale:Nephropathy with concurrent invasive thymoma is a type of paraneoplastic syndrome.Patient concerns and Diagnoses:We report a 32-year-old female with nephrotic syndrome that was first diagnosed along with invasive thymoma and treated by means of cisplatin-based chemotherapy for the thymoma. The patient initially presented with dyspnea and generalized edema. Chest radiography and computed tomography scans revealed right pleural effusion and a mass in the right middle lung field, which were confirmed by a percutaneous lung biopsy as metastatic invasive thymoma. Severe hypoalbuminemia, heavy proteinuria, hyponatremia, and hypercholesterolemia were features of the nephrotic syndrome. A kidney needle biopsy suggested focal segmental glomerulosclerosis.Interventions and Outcomes:All of the symptoms of nephrotic syndrome were resolved simultaneously during the first 2 cycles of chemotherapy. The patient was on regular follow-up with no specific treatment for nephrotic syndrome and underwent successful resection of the left pleura and anterior thymoma. The patient has shown no evidence of recurrence for 2 years.Lessons:We conclude that chemotherapy for invasive thymoma is an effective treatment for nephrotic syndrome accompanying the thymoma.
When physicians meet patients who expectorate blood, hemoptysis should be distinguished from pseudohemoptysis, i.e., bleeding from the upper respiratory tract or upper gastrointestinal tract. Herein, we present a case of hemangioma in the palate that caused bleeding mimicking hemoptysis. Hemangioma in the palate occurs rarely, but it can be easily diagnosed and the patient may avoid unnecessary tests if a physician examines the oral cavity closely at the initial visit.
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