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[Surgical treatment in the patients with ocular type myasthenia gravis associated with thymoma]
1Department of Thoracic and Cardiovascular Surgery, Tohoku University School of Medicine, Sendai, Japan.
During past 16 years, 192 patients underwent surgery for myasthenia gravis including 40 patients with pure ocular symptoms in our institute. In these 40 patients, 8 were associated with thymoma. The clinical stages of the thymomas were registered into Stage I (n = 5), Stage II (n = 1), Stage III (n = 1), Stage IV (n = 1) according to the classification of Masaoka and colleagues. All patients underwent extended thymothymectomy. The patient in stage III had been well until generalized myasthenic symptoms appeared 4 years after the surgery. Since the chest X-ray film revealed the tumor shadow on the right diaphragm, removal of the tumor was performed. Although he developed myasthenic crisis postoperatively, he is well controlled medically. Other 7 patients have been doing well. We concluded that a close postoperative follow up should be performed for the patients with ocular type myasthenia gravis associated with thymoma.
During past 16 years, 192 patients underwent surgery for myasthenia gravis including 40 patients with pure ocular symptoms in our institute. In these 40 patients, 8 were associated with thymoma. The clinical stages of the thymomas were registered into Stage I (n = 5), Stage II (n = 1), Stage III (n = 1), Stage IV (n = 1) according to the classification of Masaoka and colleagues. All patients underwent extended thymothymectomy. The patient in stage III had been well until generalized myasthenic symptoms appeared 4 years after the surgery. Since the chest X-ray film revealed the tumor shadow on the right diaphragm, removal of the tumor was performed. Although he developed myasthenic crisis postoperatively, he is well controlled medically. Other 7 patients have been doing well. We concluded that a close postoperative follow up should be performed for the patients with ocular type myasthenia gravis associated with thymoma.