Treatment of Thymoma-Associated Myasthenia Gravis With Stereotactic Body Radiotherapy: A Case Report
Authors: Caroline M. Lee, Jason D. Lee, Lisa D. Hobson-Webb, Richard S. Bedlack, Joseph K. Salama
Journal: Annals of Internal Medicine (2016)

Letters16 August 2016Treatment of Thymoma-Associated Myasthenia Gravis With Stereotactic Body Radiotherapy: A Case ReportCaroline M. Lee, MD, PhD, Jason D. Lee, MD, PhD, Lisa D. Hobson-Webb, MD, Richard S. Bedlack, MD, PhD, and Joseph K. Salama, MDCaroline M. Lee, MD, PhDFrom Duke University, Durham, North Carolina.Search for more papers by this author, Jason D. Lee, MD, PhDFrom Duke University, Durham, North Carolina.Search for more papers by this author, Lisa D. Hobson-Webb, MDFrom Duke University, Durham, North Carolina.Search for more papers by this author, Richard S. Bedlack, MD, PhDFrom Duke University, Durham, North Carolina.Search for more papers by this author, and Joseph K. Salama, MDFrom Duke University, Durham, North Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-0469 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Definitive treatment of thymoma includes surgical resection. The usual approach for thymoma with myasthenia gravis involves treating myasthenia gravis first followed by thymectomy.Objective: To describe an alternative approach for treating thymoma-associated myasthenia gravis.Case Report: A 67-year-old man presented to the emergency department with hypercarbic respiratory failure, had respiratory arrest, was intubated emergently, and then was admitted to the medical intensive care unit. He had a 6-month history of unintentional weight loss, progressive fatigue, upper and lower limb fasciculations, bilateral ptosis, dysphagia, dysphonia, and hypopnea. Chest computed tomography (CT) showed a well-circumscribed, 38 × 20–mm anterior mediastinal mass, which was ...References1. Curran WJ, Kornstein MJ, Brooks JJ, Turrisi AT. Invasive thymoma: the role of mediastinal irradiation following complete or incomplete surgical resection. J Clin Oncol. 1988;6:1722-7. [PMID: 3183702] CrossrefMedlineGoogle Scholar2. Phillips TL, Buschke F. The role of radiation therapy in myasthenia gravis. Calif Med. 1967;106:282-9. [PMID: 6046861] MedlineGoogle Scholar3. Timmerman R, Paulus R, Galvin J, Michalski J, Straube W, Bradley J, et al. Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA. 2010;303:1070-6. [PMID: 20233825] doi:10.1001/jama.2010.261 CrossrefMedlineGoogle Scholar4. Kirkpatrick JP, Kelsey CR, Palta M, Cabrera AR, Salama JK, Patel P, et al. Stereotactic body radiotherapy: a critical review for nonradiation oncologists. Cancer. 2014;120:942-54. [PMID: 24382744] doi:10.1002/cncr.28515 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Duke University, Durham, North Carolina.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0469.This article was published at www.annals.org on 15 March 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe safety and efficacy of Cyberknife® for thymic malignancyA systematic review of paraneoplastic syndromes associated with thymoma: Treatment modalities, recurrence, and outcomes in resected casesRadiotherapy and Small Cell Carcinoma With Paraneoplastic Polyneuropathy: A Case ReportBrahma D. Natarajan, MD, Corbin D. Jacobs, MD, and Joseph K. Salama, MD 16 August 2016Volume 165, Issue 4Page: 300-301KeywordsBiopsyComputed axial tomographyDisclosureFasciculationsMyasthenia gravisNervesSurgical resectionThymectomyThymomaVentilators ePublished: 15 March 2016 Issue Published: 16 August 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...