Dahal S, Bhandari N, Dhakal P, Karmacharya R M, Singh A K, Tuladhar S M, Devbhandari M
Kathmandu University School of Medical Sciences, Department of Surgery, Dhulikhel, 3, Nepal.
Kathmandu University School of Medical Sciences, Department of Surgery, Dhulikhel, 3, Nepal.
Int J Surg Case Rep. 2019;65:229-232. doi: 10.1016/j.ijscr.2019.10.069. Epub 2019 Nov 5.
Thymic abnormalities occur as hyperplasia and thymoma. Myasthenia gravis is commonly present in thymoma. Thymectomy possesses risk due to anatomical proximity with vital thoracic structures and myasthenia crisis.
Forty five years female with complaints of difficulty swallowing and weakness of upper limb muscles upon investigation showed mass in mediastinum and antibody test for myasthenia gravis positive. Medical management was done for a month followed by thymectomy. There were no intra and postoperative complications. Medical management was stopped one month after surgery and she is symptom free.
Thymectomy is the standard of care where median sternotomy is the mainstay approach to surgery. Various other surgical approaches and complications revolving around surgery has been discussed.
Surgical removal of thymoma cured myasthenia gravis in our case. We focused on proper preoperative optimization of myasthenia gravis symptoms before thymectomy.
胸腺异常表现为增生和胸腺瘤。重症肌无力在胸腺瘤中很常见。由于与重要胸部结构解剖位置接近以及重症肌无力危象，胸腺切除术存在风险。
一名45岁女性，因吞咽困难和上肢肌肉无力就诊，检查发现纵隔有肿块，重症肌无力抗体检测呈阳性。进行了一个月的药物治疗，随后进行了胸腺切除术。术中及术后均无并发症。术后一个月停止药物治疗，她已无症状。
胸腺切除术是治疗的标准方法，正中胸骨切开术是主要的手术方式。还讨论了围绕手术的各种其他手术方法和并发症。
在我们的病例中，手术切除胸腺瘤治愈了重症肌无力。我们在胸腺切除术之前专注于对重症肌无力症状进行适当的术前优化。
