Dvir Kathrin, Fortuna Gliceida M Galarza, Schwartz Michael
Department of Internal Medicine at Mount Sinai Medical Center, Miami Beach, FL, USA.
Mount Sinai Comprehensive Cancer Center, Miami Beach, FL, USA.
J Hematol. 2019 Dec;8(4):160-164. doi: 10.14740/jh557. Epub 2019 Dec 25.
A 68-year-old Caucasian man presented with gross hematuria and oral mucosal bleeding. The patient was known to have an anterior mediastinal mass, highly suspicious for thymoma, which was incidentally identified on imaging, 8 years prior. The patient then declined treatment and was lost to follow-up. On presentation, imaging re-demonstrated the anterior mediastinal mass and the patient was found to have profound pancytopenia. Bone marrow biopsy confirmed the diagnosis of aplastic anemia (AA). Despite optimal treatment, the patient expired on day 9 of admission. In this case we report an unusual presentation of thymoma-related AA (TR-AA), a rare complication of thymoma, presenting years after initial diagnosis in a patient with long standing thymoma that was left untreated as per the patient's wishes. To our best knowledge, this is the first published report where TR-AA presented 8 years after initial diagnosis in a patient with unresected and untreated thymoma.
一名68岁的白种男性出现肉眼血尿和口腔黏膜出血。该患者已知患有前纵隔肿块，高度怀疑为胸腺瘤，8年前在影像学检查中偶然发现。患者随后拒绝治疗并失访。此次就诊时，影像学检查再次显示前纵隔肿块，且患者被发现有严重全血细胞减少。骨髓活检确诊为再生障碍性贫血（AA）。尽管进行了最佳治疗，患者仍在入院第9天死亡。在此病例中，我们报告了一例胸腺oma相关AA（TR-AA）的不寻常表现，这是胸腺瘤的一种罕见并发症，在最初诊断多年后出现在一名长期患有胸腺瘤且根据患者意愿未接受治疗的患者身上。据我们所知，这是首次发表的报告，其中TR-AA在未切除和未治疗的胸腺瘤患者初次诊断8年后出现。
