胸腺肿瘤:一种罕见的神经系统疾病

S. Esmaeili, S. N. R. Alavi, Sevim Soleimani, M. Mojtahed, M. Panahi, Y. Nilipour, Bahram Haghi Ashtiani
{"title":"胸腺肿瘤:一种罕见的神经系统疾病","authors":"S. Esmaeili, S. N. R. Alavi, Sevim Soleimani, M. Mojtahed, M. Panahi, Y. Nilipour, Bahram Haghi Ashtiani","doi":"10.14740/JNR.V0I0.625","DOIUrl":null,"url":null,"abstract":"Thymoma is a rare tumor that is commonly associated with autoimmune diseases. Of these, myasthenia gravis (MG) is widely considered as the most common paraneoplastic condition. On the other hand, dermatomyositis (DM) has been rarely reported as the first presentation of non-invasive thymoma. Hereby, we describe a patient with non-invasive thymoma who initially presented with painful symmetric proximal muscle weakness with no signs of ptosis or diplopia. The needle electromyography (EMG) revealed spontaneous/insertional activity in proximal muscles. The patient was finally diagnosed with DM by muscle biopsy. Spiral chest computed tomography (CT) scan coupled with pathological assessment confirmed a non-invasive thymoma with diffuse reaction for P63 and pancytokeratin (Panck). Corticosteroids pulse therapy was initiated and the patient was referred for thymectomy. A few months later, patient began to display other neurological symptoms such as ptosis and diplopia with fluctuating pattern. As coexistence of MG was presumed, nerve conduction study (NCS) study was performed and slow repetitive nerve stimulation in proximal muscles showed more than 10% decrement in compound muscle action potential (CMAP) amplitude in repetitive nerve stimulation (RNS). Further workup revealed a positive anti-acetylcholine receptor antibody with high titer. Thus, MG was confirmed. No more treatment options were planned. Low dose corticosteroids were continued and azathioprine and pyridostigmine were prescribed. During follow-ups, symptoms were fully controlled. J Neurol Res. 2021;000(000):000-000 doi: https://doi.org/10.14740/jnr625","PeriodicalId":16489,"journal":{"name":"Journal of Neurology Research","volume":"70 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Thymic Neoplasm: A Rare Disease With Unusual Neurologic Manifestations\",\"authors\":\"S. Esmaeili, S. N. R. Alavi, Sevim Soleimani, M. Mojtahed, M. Panahi, Y. Nilipour, Bahram Haghi Ashtiani\",\"doi\":\"10.14740/JNR.V0I0.625\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Thymoma is a rare tumor that is commonly associated with autoimmune diseases. Of these, myasthenia gravis (MG) is widely considered as the most common paraneoplastic condition. On the other hand, dermatomyositis (DM) has been rarely reported as the first presentation of non-invasive thymoma. Hereby, we describe a patient with non-invasive thymoma who initially presented with painful symmetric proximal muscle weakness with no signs of ptosis or diplopia. The needle electromyography (EMG) revealed spontaneous/insertional activity in proximal muscles. The patient was finally diagnosed with DM by muscle biopsy. Spiral chest computed tomography (CT) scan coupled with pathological assessment confirmed a non-invasive thymoma with diffuse reaction for P63 and pancytokeratin (Panck). Corticosteroids pulse therapy was initiated and the patient was referred for thymectomy. A few months later, patient began to display other neurological symptoms such as ptosis and diplopia with fluctuating pattern. As coexistence of MG was presumed, nerve conduction study (NCS) study was performed and slow repetitive nerve stimulation in proximal muscles showed more than 10% decrement in compound muscle action potential (CMAP) amplitude in repetitive nerve stimulation (RNS). Further workup revealed a positive anti-acetylcholine receptor antibody with high titer. Thus, MG was confirmed. No more treatment options were planned. Low dose corticosteroids were continued and azathioprine and pyridostigmine were prescribed. During follow-ups, symptoms were fully controlled. J Neurol Res. 2021;000(000):000-000 doi: https://doi.org/10.14740/jnr625\",\"PeriodicalId\":16489,\"journal\":{\"name\":\"Journal of Neurology Research\",\"volume\":\"70 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Neurology Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14740/JNR.V0I0.625\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurology Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14740/JNR.V0I0.625","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

胸腺瘤是一种罕见的肿瘤,通常与自身免疫性疾病有关。其中,重症肌无力(MG)被广泛认为是最常见的副肿瘤疾病。另一方面,皮肌炎(DM)很少被报道为非侵袭性胸腺瘤的第一表现。在此,我们描述了一位非侵袭性胸腺瘤患者,他最初表现为痛苦的对称近端肌肉无力,没有上睑下垂或复视的迹象。针刺肌电图(EMG)显示近端肌肉自发/插入活动。患者最终通过肌肉活检诊断为糖尿病。螺旋胸部计算机断层扫描(CT)结合病理评估证实为无创胸腺瘤,P63和泛细胞角蛋白(pancytokeratin, Panck)弥漫性反应。开始使用皮质类固醇脉冲治疗,并转介患者行胸腺切除术。几个月后,患者开始出现其他神经系统症状,如上睑下垂和复视,并伴有波动模式。在假定MG共存的情况下,进行了神经传导研究(NCS),发现在近端肌肉缓慢重复神经刺激(RNS)时,复合肌肉动作电位(CMAP)幅度降低10%以上。进一步检查显示抗乙酰胆碱受体抗体阳性,高滴度。因此,MG得到了确认。没有计划更多的治疗方案。继续使用低剂量皮质类固醇,并开硫唑嘌呤和吡哆斯的明。在随访期间,症状得到完全控制。J Neurol Res. 2021;000(000):000-000 doi: https://doi.org/10.14740/jnr625
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Thymic Neoplasm: A Rare Disease With Unusual Neurologic Manifestations
Thymoma is a rare tumor that is commonly associated with autoimmune diseases. Of these, myasthenia gravis (MG) is widely considered as the most common paraneoplastic condition. On the other hand, dermatomyositis (DM) has been rarely reported as the first presentation of non-invasive thymoma. Hereby, we describe a patient with non-invasive thymoma who initially presented with painful symmetric proximal muscle weakness with no signs of ptosis or diplopia. The needle electromyography (EMG) revealed spontaneous/insertional activity in proximal muscles. The patient was finally diagnosed with DM by muscle biopsy. Spiral chest computed tomography (CT) scan coupled with pathological assessment confirmed a non-invasive thymoma with diffuse reaction for P63 and pancytokeratin (Panck). Corticosteroids pulse therapy was initiated and the patient was referred for thymectomy. A few months later, patient began to display other neurological symptoms such as ptosis and diplopia with fluctuating pattern. As coexistence of MG was presumed, nerve conduction study (NCS) study was performed and slow repetitive nerve stimulation in proximal muscles showed more than 10% decrement in compound muscle action potential (CMAP) amplitude in repetitive nerve stimulation (RNS). Further workup revealed a positive anti-acetylcholine receptor antibody with high titer. Thus, MG was confirmed. No more treatment options were planned. Low dose corticosteroids were continued and azathioprine and pyridostigmine were prescribed. During follow-ups, symptoms were fully controlled. J Neurol Res. 2021;000(000):000-000 doi: https://doi.org/10.14740/jnr625
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Non-Invasive Neuromodulation for Episodic and Chronic Migraine Headache: Preliminary Findings on Feasibility of At-Home Transcranial Direct Current Stimulation With Remote Supervision Effectiveness of Relaxation and Respiratory Exercise on Sleep Quality, Depression and Spasticity in Hemiplegic Stroke Patients: Preliminary Findings Neuro-Abilities and a Good Life Small Number of Coils With Extended Length in the Endovascular Treatment of Cerebral Aneurysm: Experience of 108 Cases in a Single-Center Motor Neuron Disease-Frontotemporal Dementia Spectrum Disorder: A Different Phenotype Related With a Novel TBK1 Gene Variant
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1