Thymolipoma Association with Myasthenia Gravis: Case Report

Othman, Sharifah A.; AlFrayyan, Othman Y; AlGhamdi, Zeead M; Makhdom, Fahd; Aljehani, Yasser; Elbawab, Hatem; Elshawarby, Mohamed

doi:10.12659/ajcr.923989

Cited by 8 publications

(7 citation statements)

References 8 publications

(14 reference statements)

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“…Grave’s disease, aplastic anemia, and lichen planus, among others. 31 , 32 Thymolipomas are more common in younger patients, usually asymptomatic, seen as large mediastinal tumors on chest radiographs. 31 In a study comparing the surgical outcome of thymolipomatous MG with thymomatous MG and non-thymomatous MG, the results were similar between patients with thymolipomatous and those with non-thymomatous MG. 33 The rate of stable remission was higher in the thymolipomatous (41.7%) and non-thymomatous (42.3%) groups compared to the thymomatous patients (28.8%).…”

Section: Discussionmentioning

confidence: 99%

Clinical delineation of myasthenia gravis in the Kingdom of Bahrain

Binfalah

Alhafnawi

Jaradat

et al. 2022

NSJ

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Methods: This was a retrospective, observational cohort study carried out at 3 hospitals in Bahrain. MG was classified into ocular or generalized types. We subdivided MG into early-onset )EOMG, ≤ 49Original Article years( or late-onset )LOMG, > 49 years(. Demographic and clinical data were recorded. The data was entered and analyzed using SPSS version 26.0.Results: 61.2% were females. The mean age at onset was 43.8±17.7 years in males and 43.1±15.7 years in females. 72.4% had EOMG. A pure ocular presentation was most common )51%(. Limb weakness was more prevalent in AChR-positive patients. The MuSK group had more severe presentation. 57.1% of patients were AChR-positive, 3.1% MuSK-positive, and 39.8% double-seronegative. Generalized disease onset was more likely with AChR. Abnormal CT chest was seen in 24/69 )35%( including thymic hyperplasia, thymoma, and thymic atrophy. Pathology findings were thymic hyperplasia )55.0%(, thymoma )30%(, thymolipoma )10%(, and normal thymus )5%(. Treatment outcomes were favorable. Conclusion:The present study revealed that MG was more common in females, with similar age at onset between males and females. The majority of patients had EOMG with ocular disease and AChR positivity. The clinical outcomes were favorable. Following a standardized protocol for MG diagnosis and workup is recommended.

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Section: Discussionmentioning

confidence: 99%

Clinical delineation of myasthenia gravis in the Kingdom of Bahrain

Binfalah

Alhafnawi

Jaradat

et al. 2022

NSJ

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“…Some patients with thymolipomas are associated with autoimmune diseases, such as myasthenia gravis, vitamin B12 deficiency, hypogammaglobulinemia, and aplastic anemia. These symptoms will be improved after the lipoma is removed (9,10). Therefore, early diagnosis and surgical intervention are very important to resect the symptoms of compression.…”

Section: Discussionmentioning

confidence: 99%

A giant tumor of the mediastinum mixed with thymocytes and adipocytes: a case report

Wang¹,

Li²,

Jiang³

et al. 2021

Gland Surg

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“…When symptomatic, thymolipomas are manifested by signs of local compression by the tumor-like mass. Patients may accuse dyspnea, chest pain, weight loss, upper respiratory infections, chronic cough, or nausea and vomiting due to esophageal compression [8,19,[43][44][45][46]. Thymolipomas may also lead to heart compression, followed by chronic heart failure [47].…”

Section:  Thymolipoma Symptoms and Diagnosismentioning

confidence: 99%

“…Thymolipoma-myasthenia gravis association is registered in approximately 2.8% to 50% of patients [15,48], being mainly observed in older people [46,48], which have autoantibodies against post-synaptic acetylcholine receptor (AChR Abs) [49]. However, according to data published by Poursadeghfard et al, in a 24-year-old patient diagnosed with thymolipoma-associated myasthenia gravis, AChR Abs have been absent but a high serum level of muscle-specific kinase (MuSK) has been detected [50].…”

Section:  Thymolipoma Symptoms and Diagnosismentioning

confidence: 99%

“…It has been also noticed that some patients may develop a progressive anemia [46], probably induced by an autoimmune erythroid precursor destruction, according to Ferreira et al, who noticed a total anemia remission after thymolipoma surgical excision, in a 73-year-old patient [16]. The correlation between thymolipoma and blood cells count is also supported by another recent report, with normalization of lymphocytes count after surgical resection, in an 8-year-old female patient showing lymphocytosis, with normal lymphocyte morphology, 80% of them belonging to T-lymphocytes type [21].…”

Section:  Thymolipoma Symptoms and Diagnosismentioning

confidence: 99%

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2021

Rom J Morphol Embryol

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Thymolipoma is an uncommon benign thymus lesion, with a partially deciphered etiopathogeny, being most frequently diagnosed in young patients, regardless of gender. Incidentally diagnosed in asymptomatic patients, larger thymolipomas lead to symptoms related to neighboring mediastinal structures compression, with an intensity which is correlated with the mass size. Our review presents the main epidemiological, pathogenic, clinicopathological and morphological characteristics of this rare pathology. Sometimes, thymolipomas may be associated with paraneoplastic syndromes, which are alleviated by the mass complete surgical resection. Imagistics may orientate the diagnosis, which is certified by the microscopic examination of the resection specimens. Extensive thymectomy remains the current therapeutic option and new tools have been developed to increase the accuracy of the surgical procedure to avoid incidental lesions of the important elements of the anterior mediastinum. Although rare, thymolipomas should be considered in the differential diagnosis of mediastinal masses and of paraneoplastic syndromes.

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Thymolipoma Association with Myasthenia Gravis: Case Report

Cited by 8 publications

References 8 publications

Clinical delineation of myasthenia gravis in the Kingdom of Bahrain

Clinical delineation of myasthenia gravis in the Kingdom of Bahrain

A giant tumor of the mediastinum mixed with thymocytes and adipocytes: a case report

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