Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2012

01-01-2012 | Thoracic Oncology

Different Characteristics of Thymomas With and Without Myasthenia Gravis

Authors: Lei Yu, MD, Xiao-jun Zhang, MD, Shan Ma, MD, Yun Jing, MD, Fei Li, MD, Mark J. Krasna, MD

Published in: Annals of Surgical Oncology | Issue 1/2012

Login to get access

Abstract

Background

The objective of this study was to evaluate the different pathological and clinical characteristics of thymomas with and without myasthenia gravis (MG) and to determine whether the presence of MG influences the prognosis in thymoma patients.

Methods

We retrospectively studied data from 228 consecutive patients operated on from 1992 to 2007 in Beijing Tongren Hospital. These thymoma patients have been subdivided into two groups: group A with MG (n = 125) and group B without MG (n = 103).

Results

There were no perioperative deaths. There were 19 inoperable cases (6 in the group with MG, 13 without MG, P = 0.035). The proportions of types A, AB, B1, B2, B3, and C thymoma in this data were 0, 22.4, 26.4, 30.4, 20.8, and 0%, respectively, in the group with MG, and 10.5, 13.4, 23.6, 24.5, 16.4, and 11.6%, respectively in the group without MG. There was a significant difference between hyperplastic paraneoplastic thymus coexisting in 28.8% patients with MG and only 5.8% in patients without MG. Microthymoma was identified in the paraneoplastic thymus of three patients with MG. There were 198 patients followed up. There was no recurrence in patients with type A, and a few patients with types AB, B1, B2, B3, and C recurred. The actuarial 5- and 10-year survival rates were 89.3 and 81.2% for patients with MG, respectively, and 90 and 78.9% for patients without MG, respectively. Within 5 years postoperatively, 6 of 9 patients with MG died of myasthenia crisis, while 6 of 7 deaths in patients without MG were attributable to inoperable tumors (stage IV) and type C thymoma.

Conclusions

MG seldom occurs in types A and C thymoma. MG of some thymoma patients was not caused by thymoma, but by the paraneoplastic thymus. The prognosis of thymomas with MG is similar to that without MG. The main cause of death is myasthenia crisis for thymoma patients with MG and stage IV and/or type C for thymoma patients without MG.
Literature
1.
López-Cano M, Ponseti-Bosch JM, Espin-Basany E, Sánchez-García JL, Armengol-Carrasco M. Clinical and pathologic predictors outcome in thymoma-associated myasthenia gravis. Ann Thorac Surg. 2003;76:1643–9.PubMedCrossRef
2.
Kondo K, Monden Y. Thymoma and myasthenia gravis: a clinical study of 1,089 patients from Japan. Ann Thorac Surg. 2005;79:219–24.PubMedCrossRef
3.
Margaritora S, Cesario A, Cusumano G, Meacci E, D’Angelillo R, Bonassi S, et al. Thirty-five-year follow-up analysis of clinical and pathologic outcomes of thymoma surgery. Ann Thorac Surg. 2010;89:245–52.PubMedCrossRef
4.
Monden Y, Nakahara K, Kagotani K, Fujii Y, Masaoka A, Kawashima Y. Myasthenia gravis with thymoma: analysis of and postoperative prognosis for 65 patients with thymomatous myasthenia gravis. Ann Thorac Surg. 1984;38:46–52.PubMedCrossRef
5.
Jaretzki III A, Barhon RJ, Ernstoff RM, Kaminski HJ, Keesey JC, Penn AS. Myasthenia gravis. Recommendations for clinical research standards. Neurology. 2000;55:16–23.PubMed
6.
Yu L, Li J, Ma S, Jiang J, Wang T, Gamliel Z, et al. Different characteristics of nonthymomatous generalized myasthenia gravis with and without oropharyngeal involvement. Ann Thorac Surg. 2007;84:1694–8.PubMedCrossRef
7.
Rosai J. Histological typing of tumors of the thymus. World Health Organization International Histological Classification of Tumors. 2nd ed. Berlin: Springer-Verlag; 1999.
8.
Detterbeck FC. Clinical value of the WHO classification system of thymoma. Ann Thorac Surg. 2006;81:2328–34.PubMedCrossRef
9.
Kondo K, Yoshizawa K, Tsuyuguchi M, Kimura S, Sumitomo M, Morita J, et al. WHO histologic classification is a prognostic indicator in thymoma. Ann Thorac Surg. 2004;77:1183–8.PubMedCrossRef
10.
Davenport E, Malthaner RA. The role of surgery in the management of thymoma: a systematic review. Ann Thorac Surg. 2008;86:673–84.PubMedCrossRef
11.
Chalabreysse L, Roy P, Cordier J-F, Loire R, Gamondes J-P, Thivolet-Bejui F. Correlation of the WHO schema for the classification of thymic epithelial neoplasms with prognosis. Am J Surg Pathol. 2002;26:1605–11.PubMedCrossRef
12.
Okumura M, Ohta M, Tateyama H, Nakagawa K, Matsumura A, Maeda H, et al. The World Health Organization histologic classification system reflects the oncologic behavior of thymoma: a clinical study of 273 patients. Cancer. 2002;94:624–32.PubMedCrossRef
13.
Nakagawa K, Asamura H, Matsuno Y, Suzuki K, Kondo H, Maeshima A, et al. Thymoma: a clinicopathologic study based on the new World Health Organization classification. J Thorac Cardiovasc Surg. 2003;126:1134–40.PubMedCrossRef
14.
Kondo K, Monden Y. Myasthenia gravis appearing after thymectomy for thymoma. Eur J Cardiothorac Surg. 2005;28:22–25.PubMedCrossRef
15.
Cheuk W, Tsang WYW, Chan JKC. Microthymoma: definition of the entity and distinction from nodular hyperplasia of the thymic epithelium (so-called microscopic thymoma). Am J Surg Pathol. 2005;29:415–9.PubMedCrossRef
16.
Bulkley GB, Bass KN, Stephenson GR, Diener-West M, George S, Reilly PA, et al. Extended cervicomediastinal thymectomy in the integrated management of myasthenia gravis. Ann Surg. 1997;226:324–35.PubMedCrossRef
17.
Okumura M, Milyoshi S, Takeuchi Y, Yoon HE, Minami M, Takeda SL, et al. Results of surgical treatment of thymoma with special reference to the involved organs. J Thorac Cardiovasc Surg. 1999;117:605–13.PubMedCrossRef
18.
Curran WJ Jr, Kornstein MJ, Brooks JJ, Turrisi AT 3rd. Invasive thymoma: the role of mediastinal irradiation following complete or incomplete surgical resection. J Clin Oncol. 1988;6:1722–7.PubMed
19.
Kondo K, Monden Y. Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg. 2003;76:878–84.PubMedCrossRef
20.
Maggi G, Casadio C, Cavallo A, Cianci R, Molinatti M, Ruffini E. Thymoma: results of 241 operated cases. Ann Thorac Surg. 1991;51:152–6.PubMedCrossRef
Metadata
Title
Different Characteristics of Thymomas With and Without Myasthenia Gravis
Authors
Lei Yu, MD
Xiao-jun Zhang, MD
Shan Ma, MD
Yun Jing, MD
Fei Li, MD
Mark J. Krasna, MD
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1896-8

Other articles of this Issue 1/2012

Annals of Surgical Oncology 1/2012 Go to the issue

Bone and Soft Tissue Sarcomas

Incorporation of Adjuvant Therapy into the Multimodality Management of Gastrointestinal Stromal Tumors of the Stomach in the United States

Gynecologic Oncology

Lymphoceles, Lymphorrhea, and Lymphedema after Laparoscopic and Open Endometrial Cancer Staging

Melanomas

Incomplete Sentinel Node Biopsy Is Not Clearly Related to Survival or Regional Recurrence in Cutaneous Melanoma Patients

Colorectal Cancer

Robotic Coloanal Anastomosis with or without Intersphincteric Resection for Low Rectal Cancer: Starting with the Perianal Approach Followed by Robotic Procedure

Breast Oncology

Changes in Psychosocial Functioning 1 Year After Mastectomy Alone, Delayed Breast Reconstruction, or Immediate Breast Reconstruction

Healthcare Policy and Outcomes

Impact of Radiation Therapy Sequence on Survival Among Patients With Resected Pancreatic Head Ductal Carcinoma