Thymoma in patients with MG - Characteristics and long-term outcome

被引:136
作者
Evoli, A
Minisci, C
Di Schino, C
Marsili, F
Punzi, C
Batocchi, AP
Tonali, PA
Doglietto, GB
Granone, P
Trodella, L
Cassano, A
Lauriola, L
机构
[1] Catholic Univ, Neurol Inst, I-00168 Rome, Italy
[2] Catholic Univ, Inst Surg, I-00168 Rome, Italy
[3] Catholic Univ, Inst Radiol, I-00168 Rome, Italy
[4] Catholic Univ, Inst Internal Med, I-00168 Rome, Italy
[5] Catholic Univ, Inst Pathol, I-00168 Rome, Italy
关键词
D O I
10.1212/01.WNL.0000032502.89361.0C
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To examine the characteristics of thymoma when associated with MG and to evaluate those conditions that can complicate management and affect survival. Methods: The study includes 207 myasthenic patients who were operated on for thymoma, with at least 1-year follow-up from surgery. MG severity and response to treatment, the occurrence of paraneoplastic diseases and extrathymic malignancies, thymoma histologic types and stages, adjuvant therapy, tumor recurrences, and causes of death were recorded. Results: MG-associated thymoma was predominantly of B type and was invasive in the majority of patients. MG was generally severe, and most patients remained dependent on immunosuppressive therapy. Other paraneoplastic disorders and extrathymic malignancies were found in 9.66 and 11.11% of patients. Thymoma recurrences occurred in 18 of 115 patients with invasive tumors (15.65%) and were often associated with the onset/aggravation of autoimmune diseases. On completion of the study, MG and thymoma accounted for a similar mortality rate. Conclusions: Thymoma should be considered as a potentially malignant tumor requiring prolonged follow-up. The presence of myasthenic weakness can still complicate its management. Thymoma-related deaths are bound to outnumber those due to MG in the future.
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页码:1844 / 1850
页数:7
相关论文
共 41 条
[1]
Thymoma-associated systemic lupus erythematosus, exacerbating after thymectomy. A case report and review of the literature [J].
Boonen, A ;
Rennenberg, R ;
van der Linden, S .
RHEUMATOLOGY, 2000, 39 (09) :1044-1046
[2]
Potassium channel antibodies in two patients with reversible limbic encephalitis [J].
Buckley, C ;
Oger, J ;
Clover, L ;
Tüzün, E ;
Carpenter, K ;
Jackson, M ;
Vincent, A .
ANNALS OF NEUROLOGY, 2001, 50 (01) :73-78
[3]
Do titin and cytokine antibodies in MG patients predict thymoma or thymoma recurrence? [J].
Buckley, C ;
Newsom-Davis, J ;
Willcox, N ;
Vincent, A .
NEUROLOGY, 2001, 57 (09) :1579-1582
[4]
Mature, long-lived CD4+ and CD8+ T cells are generated by the thymoma in myasthenia gravis [J].
Buckley, C ;
Douek, D ;
Newsom-Davis, J ;
Vincent, A ;
Willcox, N .
ANNALS OF NEUROLOGY, 2001, 50 (01) :64-72
[5]
Predictors of outcome in thymectomy for myasthenia gravis [J].
Budde, JM ;
Morris, CD ;
Gal, AA ;
Mansour, KA ;
Miller, JI .
ANNALS OF THORACIC SURGERY, 2001, 72 (01) :197-202
[6]
Mycophenolate mofetil for myasthenia gravis: An open-label pilot study [J].
Ciafaloni, E ;
Massey, JM ;
Tucker-Lipscomb, B ;
Sanders, DB .
NEUROLOGY, 2001, 56 (01) :97-99
[7]
COWEN D, 1995, RADIOTHER ONCOL, V43, P9
[8]
Multiple paraneoplastic diseases associated with thymoma [J].
Evoli, A ;
Lo Monaco, M ;
Marra, R ;
Lino, MM ;
Batocchi, AP ;
Tonali, PA .
NEUROMUSCULAR DISORDERS, 1999, 9 (08) :601-603
[9]
A practical guide to the recognition and management of Myasthenia gravis [J].
Evoli, A ;
Batocchi, AP ;
Tonali, P .
DRUGS, 1996, 52 (05) :662-670
[10]
THYMECTOMY IN THE TREATMENT OF MYASTHENIA-GRAVIS - REPORT OF 247 PATIENTS [J].
EVOLI, A ;
BATOCCHI, AP ;
PROVENZANO, C ;
RICCI, E ;
TONALI, P .
JOURNAL OF NEUROLOGY, 1988, 235 (05) :272-276