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An unusual presentation of thymoma: dysgeusia, ulcerative colitis, keratoconjunctivitis sicca, autoimmune retinopathy and myasthenia gravis
  1. Priyanka Sanghi1,2 and
  2. Fion Bremner2
  1. 1Moorfields Eye Hospital NHS Foundation Trust, London, UK
  2. 2Department of Neuro-Ophthalmology, National Hospital for Neurology and Neurosurgery, London, UK
  1. Correspondence to Dr Priyanka Sanghi; priyankas646{at}hotmail.com

Abstract

A 41-year-old female presented with dysgeusia, dry eyes, nyctalopia with progressive visual field constriction (due to autoimmune retinopathy) and gastrointestinal symptoms (due to ulcerative colitis). She was subsequently admitted to intensive care with a myasthenic crisis, and CT of the thorax demonstrated a thymoma.

Following thymectomy and adjuvant radiotherapy, she has remained in complete remission from her ulcerative colitis and myasthenia gravis, her retinopathy has stabilised and there has been no thymoma recurrence over a 10-year postoperative period. There was a brief relapse of her dysgeusia (causing weight loss) and dry eye symptoms 3 years after her surgery, which resolved 8 months later. While the association of thymomas with paraneoplastic syndromes (PNS) is well established, it is unusual to present with multiple PNS, and some of these have only been documented in sparse case reports to date. Thymectomy played a crucial role in improvement and stabilisation of her PNS.

  • ulcerative colitis
  • immunology
  • neuroopthalmology
  • respiratory cancer
  • retina

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Footnotes

  • Contributors The patient was under the care of FB over a 10-year follow-up period. Report was written by PS, and edited and supervised by FB. Figures were supplied by FB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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