Denayer M A, Rao K R, Wirz D, McNally D
J Neurol Sci. 1986 Nov;76(1):23-30. doi: 10.1016/0022-510x(86)90139-5.
We report the case of a 62-year-old woman who presented in myasthenic crisis 22 years after radiation- and chemotherapy of an invasive thymoma which occurred during pregnancy. There was no evidence of recurrence of the thymoma at its original site, but an isolated hepatic metastasis was discovered. Biopsy of the mass revealed a spindle cell thymoma, whereas the original histology was that of a mixed round and spindle cell thymoma with moderate lymphocytic infiltration. The patient expired in spite of treatment with steroids, pyridostigmine bromide and plasma exchange on the one hand and cyclophosphamide with adriamycin on the other. To our knowledge, 22 years is the longest reported interval for the appearance of metastatic thymoma and myasthenia gravis after the diagnosis and apparent cure of a primary thymoma. This is also the only reported case of thymoma occurring during pregnancy but not associated with a rapidly fatal outcome.
我们报告了一例62岁女性患者的病例，该患者在孕期发生侵袭性胸腺瘤，接受放疗和化疗22年后出现重症肌无力危象。胸腺瘤原发病灶处无复发迹象，但发现了孤立的肝转移灶。对肿块进行活检显示为梭形细胞胸腺瘤，而最初的组织学表现为混合性圆形和梭形细胞胸腺瘤伴中度淋巴细胞浸润。尽管一方面给予类固醇、溴吡斯的明和血浆置换治疗，另一方面给予环磷酰胺和阿霉素治疗，患者仍死亡。据我们所知，22年是诊断并表面治愈原发性胸腺瘤后转移性胸腺瘤和重症肌无力出现的最长报告间隔时间。这也是唯一一例孕期发生胸腺瘤但未导致快速死亡结局的报告病例。
