Zheng Yu, Cai Yi-Zhou, Zhang Han-Lu, Wang Zi-Hao, Wang Yun
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
West China School of Public Health, Sichuan University, Chengdu 610041, China.
J Thorac Dis. 2017 Jun;9(6):E565-E569. doi: 10.21037/jtd.2017.05.82.
We herein firstly reported that a patient with thymoma-associated pemphigus (TAP) underwent a robotic-assisted trans-subxiphoid thoracoscopic extended thymectomy and then achieved stable resolution. The patient, a 47-year-old male, was first admitted to our hospital owing to stomatitis and bullae of the trunk after four months' prednisone treatment. On admission, chest computed tomography (CT) revealed an anterior-mediastinal mass and it was initially diagnosed as a thymoma. He was positive for anti-BP (bullous pemphigoid)-180 antibody and anti-desmoglein 3 antibody. Then, a robotic-assisted thymectomy was performed, following which, the anti-BP-180 and anti-desmoglein 3 antibody titres have declined. The patient's mucocutaneous lesions improved, and the steroid dose was gradually decreased from 60 to 40 mg/day. According to previous reports, and the experience of the presented case, we therefore believe that early extended thymectomy is an effective therapeutic intervention for TAP.
我们在此首次报告，一名患有胸腺瘤相关性天疱疮（TAP）的患者接受了机器人辅助经剑突下胸腔镜扩大胸腺切除术，随后病情得到稳定缓解。该患者为47岁男性，在接受泼尼松治疗四个月后，因口腔炎和躯干水疱首次入住我院。入院时，胸部计算机断层扫描（CT）显示前纵隔肿块，最初诊断为胸腺瘤。他的抗BP（大疱性类天疱疮）-180抗体和抗桥粒芯糖蛋白3抗体呈阳性。随后，进行了机器人辅助胸腺切除术，术后抗BP-180和抗桥粒芯糖蛋白3抗体滴度下降。患者的黏膜皮肤病变有所改善，类固醇剂量逐渐从60毫克/天降至40毫克/天。根据既往报道以及本病例的经验，我们因此认为早期扩大胸腺切除术是治疗TAP的有效治疗干预措施。
