一例单孔电视辅助胸腔镜下胸腺瘤合并重症肌无力及毒性多结节性甲状腺肿的胸腺切除术病例。
A case of uniportal VATS thymectomy for Thymoma associated with myasthenia gravis and toxic multinodular goiter.
作者信息
Dukmak Osama N, Dweik Ruba, Hashlamoun Nadeen, Qawasmeh Rahaf, Al Mohtasib Mohammad Eid, Asbeh Yousef Abu
机构信息
Faculty of Medicine, Al-Quds University, West Bank, Palestine.
Faculty of Medicine, Al-Quds University, West Bank, Palestine.
出版信息
Int J Surg Case Rep. 2022 Jun;95:107183. doi: 10.1016/j.ijscr.2022.107183. Epub 2022 May 11.
BACKGROUND
Thymoma is a rare neoplasm, which may be associated with autoimmune disorders, the occurrence of hyperthyroidism in the patients with thymoma is rare.
CLINICAL PRESENTATION
Here we present an extremely rare case of a 56-year-old female patient who was discovered to have malignant thymoma with associated myasthenia gravis and hyperthyroidism due to toxic multinodular goiter. Our patient started to complain of difficulty breathing and swallowing, Chest CT scan was done and revealed an anterior mediastinal mass, measures about 4.1 × 3.1 × 2.2 cm with enlarged lymph node mostly representing thymoma. Complete thymectomy was performed via uniportal video-assisted thoracoscopic surgery, and the patient's postoperative recovery was uneventful. Microscopic histopathology findings corresponded to thymoma type B1.
CONCLUSION
The coexistence of thymoma, MG and toxic multinodular goiter is extremely rare. MG should always be suspected in a patient with thymoma. VATS thymectomy has been increasingly used to treat thymoma as it has several advantages over open surgery.
背景
胸腺瘤是一种罕见的肿瘤，可能与自身免疫性疾病有关，胸腺瘤患者发生甲状腺功能亢进症的情况较为罕见。
临床表现
在此，我们报告一例极为罕见的病例，一名56岁女性患者被发现患有恶性胸腺瘤，伴有重症肌无力和因毒性多结节性甲状腺肿导致的甲状腺功能亢进症。我们的患者开始抱怨呼吸和吞咽困难，进行了胸部CT扫描，结果显示前纵隔有一个肿块，大小约为4.1×3.1×2.2厘米，伴有肿大的淋巴结，主要为胸腺瘤。通过单孔电视辅助胸腔镜手术进行了完整的胸腺切除术，患者术后恢复顺利。显微镜下组织病理学检查结果符合B1型胸腺瘤。
结论
胸腺瘤、重症肌无力和毒性多结节性甲状腺肿同时存在极为罕见。胸腺瘤患者应始终怀疑患有重症肌无力。电视辅助胸腔镜胸腺切除术越来越多地用于治疗胸腺瘤，因为它比开放手术有几个优点。
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