Akimaru K, Shoji T, Masugi Y
Second Department of Surgery, Nippon Medical School.
Nihon Ika Daigaku Zasshi. 1993 Aug;60(4):241-4. doi: 10.1272/jnms1923.60.241.
A forty-nine-year-old female patient, complaining of swallowing difficulties and general fatigue, was admitted to the first hospital of Nippon Medical School. At the age of 32, she was operated on for the removal of a well encapsulated non-invasive thymoma. Since then, she had been well till the age of 46, when chest X-ray films showed a recurrent thymoma which was excised together with the complete thymic tissues. One year later, she developed myasthenia gravis (MG) with a ptotic right upper eyelid and general fatigue. Subsequently, she was placed on medication. After 21 months, however, she died of myasthenic crisis in spite of vigorous respiratory and nutritional support. The autopsy revealed a small residual thymoma on the left lung, and systemic atrophy of the skeletal muscles. In this paper, the mechanism of post-thymectomy MG and the recurrence of non-invasive thymoma are discussed.
一名49岁女性患者，因吞咽困难和全身乏力入院，入住日本医科大学第一医院。32岁时，她接受了手术，切除了一个包膜完整的非侵袭性胸腺瘤。从那时起，她一直状况良好，直到46岁时，胸部X光片显示胸腺瘤复发，遂连同完整的胸腺组织一并切除。一年后，她患上了重症肌无力（MG），右上眼睑下垂且全身乏力。随后，她开始接受药物治疗。然而，21个月后，尽管给予了积极的呼吸和营养支持，她仍死于肌无力危象。尸检发现左肺有一个小的残留胸腺瘤，以及骨骼肌的全身性萎缩。本文讨论了胸腺切除术后重症肌无力的发病机制和非侵袭性胸腺瘤的复发情况。
