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根治性胸腺切除术后3年因胸膜植入物导致的复发性重症肌无力。

Recurrent myasthenia gravis due to a pleural implant 3 years after radical thymectomy.

作者信息

Heyman Stijn R G, De Raeve Hendrik, Mercelis Rudy, De Pooter Christel, Van Schil Paul

机构信息

Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp, Belgium.

出版信息

Ann Thorac Surg. 2008 Jul;86(1):299-301. doi: 10.1016/j.athoracsur.2008.01.030.

Abstract

Although recurrence of a thymoma is rare, pleural dissemination or local relapses have been described. We present a patient who underwent complete thymectomy for a thymoma, type AB according to the World Health Organization classification and stage II according to Masaoka, followed by adjuvant radiotherapy. Three years later, a relapse of the myasthenic symptoms occurred. An isolated pleural implant above the left diaphragm was removed by video-assisted thoracoscopy. Pathology confirmed the recurrence of the thymoma. As this is a rare occurrence, no precise therapeutic guidelines exist. In our case, surgical resection of the recurrence with adjuvant immunomodulating therapy for myasthenia provided good results.

摘要

虽然胸腺瘤复发罕见,但已有胸膜播散或局部复发的报道。我们报告一例患者,根据世界卫生组织分类为AB型胸腺瘤,按照马萨oka分期为II期,接受了胸腺完整切除术,随后进行辅助放疗。三年后,肌无力症状复发。通过电视辅助胸腔镜切除了左膈上方孤立的胸膜种植体。病理证实为胸腺瘤复发。由于这种情况罕见,不存在精确的治疗指南。在我们的病例中,手术切除复发灶并辅以针对肌无力的免疫调节治疗取得了良好效果。

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