Schumm F, Brinkmann A, Fateh-Moghadam A
Dtsch Med Wochenschr. 1984 Aug 17;109(33):1244-6. doi: 10.1055/s-2008-1069357.
In a 46-year-old female patient with malignant thymoma and concomitant myasthenia gravis relapse with gravitational metastases occurred 6 1/2 years after the first operation. Metastases could be removed surgically only partially and were subsequently irradiated with 50 Gy. After 3 1/2 years renewed metastatic growth occurred. Until then the concomitant myasthenia had been stable during treatment with pyridostigmine and azathioprin and intermittent prednisone; acetylcholine receptor antibody titres had remained largely stable. Combined cytostatic treatment with vincristine, cyclophosphamide, prednisone and doxorubicin or cisplatin led to regression of metastases during the observation period of 1 1/2 years and at the same time to stabilisation of the myasthenia. Acetylcholine receptor antibody titres decreased and this was roughly paralleled by clinical improvement. Whereas there is no obvious correlation of antibodies against acetylcholine-receptor protein and tendency of tumour growth there is good agreement with the course of the accompanying myasthenia.
一名46岁女性患者患有恶性胸腺瘤，同时伴有重症肌无力。首次手术后6年半出现重力性转移复发。转移灶只能部分通过手术切除，随后接受了50 Gy的放射治疗。3年半后出现了新的转移灶生长。在此之前，在使用吡啶斯的明、硫唑嘌呤和间歇性泼尼松治疗期间，伴随的重症肌无力病情一直稳定；乙酰胆碱受体抗体滴度基本保持稳定。使用长春新碱、环磷酰胺、泼尼松和阿霉素或顺铂进行联合细胞抑制治疗，在1年半的观察期内使转移灶消退，同时使重症肌无力病情稳定。乙酰胆碱受体抗体滴度下降，这与临床改善大致平行。虽然抗乙酰胆碱受体蛋白抗体与肿瘤生长趋势之间没有明显相关性，但与伴随的重症肌无力病程有很好的一致性。
