Jazi Hourossadat Hashemi, Harmon David M, Tran Tuan, Denham Claude
Departments of Internal Medicine (Jazi), Pathology (Tran), and Oncology (Denham), Baylor University Medical Center; and Texas A&M University College of Medicine (Harmon), Dallas, Texas.
Proc (Bayl Univ Med Cent). 2017 Jul;30(3):330-332. doi: 10.1080/08998280.2017.11929636.
We describe a patient who initially presented with a mixed thymic tumor and developed myasthenia gravis 8 years following thymectomy with recurrence of metastatic disease. Metastasis to the pleura, mediastinum, and cervical spine was identified with a positron emission tomography scan when this patient presented with recurring pneumonias and atrial fibrillation. The presentation and diagnosis were clouded by multiple courses of prednisone and chemotherapy for respiratory complications and metastatic disease, respectively. Classical myasthenia gravis symptoms emerged when his prednisone was tapered. The delayed presentation of paraneoplastic disease and the rare metastatic site make this case particularly unusual.
我们描述了一名最初表现为混合性胸腺肿瘤的患者，在胸腺切除术后8年出现重症肌无力，且伴有转移性疾病复发。当该患者因复发性肺炎和心房颤动就诊时，正电子发射断层扫描发现胸膜、纵隔和颈椎有转移。由于分别针对呼吸并发症和转移性疾病进行了多疗程的泼尼松和化疗，其临床表现和诊断变得模糊不清。当他的泼尼松逐渐减量时，典型的重症肌无力症状出现了。副肿瘤性疾病的延迟出现以及罕见的转移部位使得这个病例尤为特殊。
