Abstract In 33 thymic tumors myasthenia gravis was associated in 17. Half of these were invasive lesions, whereas only one fourth of the other 16 were invasive. Response of the myasthenia gravis to thymectomy was good to excellent in 44%. An average follow-up period of 5½ years revealed seven late deaths, five of them in patients with myasthenia gravis. Four of the seven late deaths were in patients with invasive tumors. In those patients with thymomas and associated myasthenia gravis, the response of the myasthenia to surgical excision of the thymoma is not predictable, although improvement can be expected in some. In addition, since approximately one half of these lesions are invasive, prompt exploration is essential if later invasion of vital structures by tumor is to be prevented. Postoperative radiation therapy is advised in all patients with invasive lesions, as well as in those with large, nonresectable tumors. References 1. Weigert C: Pathogisch-Anatomischer Beitrag zur Erbschen Krankheit (myasthenia gravis) . Neurol Centralbl 20:597-601, 1901. 2. Schumacher and Roth: Thymektomie bei einem Fall von Morbus Basedowi mit Myasthenie . Mitt Grenzgeb Med Chir 25:746-756, 1913. 3. Andrus WD, Foot NC: Report of a large thymic tumor successfully removed by operation . J Thorac Surg 6:648-659, 1937. 4. Blalock A, Mason MF, Morgan HJ, et al: Myasthenia gravis and tumors of the thymic region: Report of a case in which the tumor was removed . Ann Surg 110:540-560, 1939.Crossref 5. Katz A, Lattes R: Granulomatous thymoma or Hodgkin's disease of thymus? A clinical and histologic study and re-evaluation . Cancer 23:1-15, 1969.Crossref 6. Fechner RE: Hodgkin's disease of the thymus . Cancer 23:16-23, 1969.Crossref 7. Freeman Z: Pure red cell anemia and thymoma . Brit Med J 1( (pt 2) ):1390-1392, 1960.Crossref 8. Field EO, Caughi MN, Blackett NM, et al: Marrow-suppressing factors in the blood in pure red-cell aplasia, thymoma and Hodgkin's disease . Brit J Haemat 15:101-110, 1968.Crossref 9. MacLean LD, Zak SJ, Varco RL, et al: Thymic tumors and acquired aggamaglobulinemia: A clinical and experimental study of the immune response . Surgery 40:1010-1017, 1956. 10. Scholz DA, Bahn RC: Thymic tumors associated with Cushing's syndrome: Review of three cases . Mayo Clin Proc 34:433-441, 1959. 11. Bernatz PE, Harrison EG, Clagett OT: Thymoma: A clinicopathologic study . J Thorac Cardiovasc Surg 42:424-444, 1961. 12. Lattes R: Thymoma and other tumors of the thymus: An analysis of 107 cases . Cancer 15:1224-1260, 1926.Crossref 13. Sawyers JL, Foster JH: Surgical treatment of thymoma . Arch Surg 96:814-817, 1968.Crossref 14. Perlo VP, Poskanzer DC, Schwab RS, et al: Myasthenia gravis: Evaluation of treatment in 1,355 patients . Neurology 16:431-439, 1966.Crossref 15. Buckberg GD, Herrmann C Jr, Dillon JB, et al: A further evaluation of thymectomy for myasthenia gravis . J Thorac Cardiovasc Surg 53:401-411, 1967. 16. Effler DB, McCormack LJ: Thymic neoplasms . J Thorac Cardiovasc Surg 31:60-77, 1956.
Archives of Surgery – American Medical Association
Published: Jul 1, 1971