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Case Reports

Recurrent Myasthenia Gravis Due to a Pleural Implant 3 Years After Radical Thymectomy

^a Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp, Belgium
^b Department of Pathology, Antwerp University Hospital, Antwerp, Belgium
^c Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
^d Department of Radiotherapy, St. Augustinus Hospital, Antwerp, Belgium

Accepted for publication January 10, 2008.

^_* Address correspondence to Dr Heyman, Graaf Van Hoornstraat 23, Antwerp, 2000, Belgium (Email: stijn_heyman{at}hotmail.com).

Although recurrence of a thymoma is rare, pleural dissemination or local relapses have been described. We present a patient who underwent complete thymectomy for a thymoma, type AB according to the World Health Organization classification and stage II according to Masaoka, followed by adjuvant radiotherapy. Three years later, a relapse of the myasthenic symptoms occurred. An isolated pleural implant above the left diaphragm was removed by video-assisted thoracoscopy. Pathology confirmed the recurrence of the thymoma. As this is a rare occurrence, no precise therapeutic guidelines exist. In our case, surgical resection of the recurrence with adjuvant immunomodulating therapy for myasthenia provided good results.

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