Intrapulmonary ectopic thymoma with severe myasthenia gravis after thymoma surgery: A case report and literature review

Abstract

Abstract Background: Ectopic thymoma are rare thymic tumorslocated in regions other than the anterior mediastinum. It is even rarer to find patients with intrapulmonary ectopic thymoma and myasthenia gravis . In particular, patients with pulmonary masses with pulmonary symptoms such as cough, sputum, and dyspnea are highly susceptible to misdiagnosis. Here, we report the clinical data, tumor pathology, treatment, and prognosis of a patient with intrapulmonary ectopic thymoma and myasthenia gravis after thymoma surgery and review the relevant literature. Case presentation: Forty-five days ago, a 54-year-old female patient with a 12-year earlier clinical diagnosis of myasthenia gravis (type II) with thymoma (type B1) and thymoma resection presented with ptosis of the right upper eyelid with double vision. Enhanced chest computed tomography revealed a tumorous lesion in the supraglottic segment of the upper lobe of the left lung. After wedge resection of the upper lobe of the lung, the pathological biopsy and immunohistochemistry suggested pulmonary thymoma (mainly type B3). After surgery, the patient was treated with long-term oral pyridostigmine bromide combined with adjuvant radiation therapy. Discussions and Conclusion: This case report and review of the related literature show that even after removal for thymoma, there is a possibility of recurrence and unexpected sites of recurrence, such as the lungs.It is also important to consider the possibility of other rare neurological diseases such as thymoma located in the lungs in addition to lung tumors in patients with pulmonary masses, whether the patient presents with or without myasthenia gravis.Early lung biopsy can lead to early identification and treatment of the disease.This case provide a reference for the clinical diagnosis of intrapulmonary ectopic thymoma and improve its clinical treatment.