Myasthenia gravis appearing after thymectomy heralding recurrent thymoma

Beckers, Paul A. J.; Mercelis, Rudy; Heyman, Stijn; Verheuen, Lies; Lauwers, Patrick; Hendriks, Jeroen; Schil, Paul Van

doi:10.1080/00015458.2018.1438556

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Some previous studies (8, 11–20) focused solely on the relationship between a single CT finding and clinical features, such as myasthenia gravis, adjacent lung invasion, surgical resectability, and postoperative recurrence, whereas others focused on clinical staging or World Health Organization (WHO) histological classification (21–24). One retrospective analysis aimed to identify metastasis or recurrence of thymomas according to longitudinal imaging studies and cross-sectional follow-up imaging after surgery (25).…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Computed Tomography Imaging Features and Clinical Characteristics, Masaoka–Koga Stages, and World Health Organization Histological Classifications of Thymoma

et al. 2019

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Objectives: Computed tomography (CT) is an important technique for evaluating the condition and prognosis of patients with thymomas, and it provides guidance regarding treatment strategies. However, the correlation between CT imaging features, described using standard report terms, and clinical characteristics, Masaoka–Koga stages, and World Health Organization (WHO) classifications of patients with thymomas has not been described in detail nor has risk factor analysis been conducted.Methods: Overall, 159 patients with thymomas who underwent preoperative contrast-enhanced CT between September 2011 and December 2018 were retrospectively reviewed. We assessed the clinical information, CT imaging features, and pathological findings for each patient. A total of 89 patients were specially used to evaluate postoperative recurrence or metastasis between September 2011 and December 2015 to obtain an appropriate observation period. The relationship between CT imaging features and clinical characteristics, Masaoka–Koga stage, and WHO histological classification were analyzed, and related risk factors based on CT imaging features were identified.Results: CT imaging features did not significantly differ based on sex or age. Some imaging features demonstrated significant differences between the groups with and without related clinical characteristics. Contour (odds ratio [OR] = 3.711, P = 0.005), abutment ≥50% (OR = 4.277, P = 0.02), and adjacent lung abnormalities (OR = 3.916 P = 0.031) were independent risk factors for relapse or metastasis. Among all imaging features, there were significant differences between stage I/II and III/IV lesions in tumor size, calcification, infiltration of surrounding fat, vascular invasion, pleural nodules, elevated hemidiaphragm, and pulmonary nodules. Tumor size (odds ratio = 1.261, P = 0.014), vascular invasion (OR = 2.526, P = 0.023), pleural nodules (OR = 2.22, P = 0.048), and pulmonary nodules (OR = 3.106, P = 0.006) were identified as independent risk factors. Tumor size, contour, internal density, infiltration of surrounding fat, and pleural effusion significantly differed between low- and high-risk thymomas. Tumor size (OR = 1.183, P = 0.048), contour (OR = 2.288, P = 0.003), internal density (OR = 2.192, P = 0.024), and infiltration of surrounding fat (OR = 2.811 P = 0.005) were independent risk factors.Conclusions: Some CT imaging features demonstrated significant correlations with clinical characteristics, Masaoka–Koga clinical stages, and WHO histological classifications in patients with thymomas. Familiarity with CT features identified as independent risk factors for these related clinical characteristics can facilitate preoperative evaluation and treatment management for the patients with thymoma.

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Section: Introductionmentioning

confidence: 99%

Relationship Between Computed Tomography Imaging Features and Clinical Characteristics, Masaoka–Koga Stages, and World Health Organization Histological Classifications of Thymoma

et al. 2019

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“…The appearance of MG after thymectomy has previously been reported in the literature. 27,28 Eculizumab was chosen in the seven patients described because their disease could not be adequately controlled despite being on chronic IVIG (three patients) or chronic PLEX (three patients) or the patient was experiencing negative side effects due to long-term, high-dose steroid use (one patient, 20 mg prednisone for 30 years). These cases align with the Health Canada indication for eculizumab in generalized MG and with the population in the REGAIN trial.…”

Section: Illustrative Cases Of Eculizumab In Myasthenia Gravismentioning

confidence: 99%

Complement Inhibition in Myasthenia Gravis and Neuromyelitis Optica Spectrum Disorder

Dodig

Genge

Selchen

et al. 2021

Can. J. Neurol. Sci.

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The complement system is a tightly controlled signaling network that plays a role in innate immune surveillance. However, abnormal signaling through this pathway contributes to tissue damage in several inflammatory, autoimmune, and degenerative diseases. Myasthenia gravis (MG) and neuromyelitis optica spectrum disorders (NMOSD) have complement dysfunction at the core of pathogenesis, providing a strong rationale for therapeutic targeting of complement components. The purpose of this paper is to briefly review the role of complement activation in the pathogenesis of MG and NMOSD, to discuss the rationale and evidence for complement inhibition as a method to manage these diseases, and to provide a Canadian perspective on the use of complement inhibition therapy through real-world cases of MG and NMOSD.

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Report of a case of necrotizing autoimmune myopathy with thymoma-associated myasthenia gravis

Huang

Zhou

Yao

2020

International Journal of Neuroscience

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Myasthenia gravis appearing after thymectomy heralding recurrent thymoma

Abstract: New-onset MG postthymectomy heralds recurrent disease in 3% of cases. Thorough screening is needed in such patients.

Cited by 3 publications

References 10 publications

Relationship Between Computed Tomography Imaging Features and Clinical Characteristics, Masaoka–Koga Stages, and World Health Organization Histological Classifications of Thymoma

Relationship Between Computed Tomography Imaging Features and Clinical Characteristics, Masaoka–Koga Stages, and World Health Organization Histological Classifications of Thymoma

Complement Inhibition in Myasthenia Gravis and Neuromyelitis Optica Spectrum Disorder

Report of a case of necrotizing autoimmune myopathy with thymoma-associated myasthenia gravis

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