CASE REPORTS  THORACIC PAPERS 

The Journal of Cardiovascular Surgery 1999 December;40(6):893-5

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Extended thymectomy for myasthenia gravis in an octogenarian. A case report

Hamada Y., Sakai Y., Ito H., Ichikawa H., Morishita Y.

From the Department of Chest Surgery Department of Neurology and Department of Pathology Maebashi Red Cross Hospital and Second Department of Surgery Gunma University School of Medicine, Maebashi, Japan

An 86-­year-old ­woman ­with myas­thenia ­gravis suc­cess­fully under­went an ­extended thy­mec­tomy. The ­patient had a 2-­year his­tory of gen­er­al­ized myas­thenia and had lim­ited ­response to anti­chol­i­nes­te­rases and ster­oids. An ­extended thy­mec­tomy was suc­cess­fully per­formed in the ­usual ­fashion. The post­op­er­a­tive ­course was ­uneventful ­except for an epi­sode of psy­chosis prob­ably due to post­op­er­a­tive ­steroid ­therapy. The ­steroid ­dosage was grad­u­ally ­reduced to 5 mg/day ­over ­seven ­months ­after the oper­a­tion, ­during ­which she ­became ­fully asymp­to­matic. No symp­toms due to myas­thenia ­have sur­faced for ­over 2 ­years ­after sur­gery. ­Although eld­erly ­patients are usu­ally con­sid­ered to be ­less respon­sive to an oper­a­tion, thy­mec­tomy may some­times be the treat­ment of ­choice for myas­thenia ­gravis ­even in octo­ge­nar­ians.