PT  - JOURNAL ARTICLE
AU  - Justin Tyler Van Backer
AU  - Alex Cedeno-Rodriguez
AU  - John Nabagiez
TI  - Third distant recurrence of benign thymoma in a patient with myasthenia gravis
AID  - 10.1136/bcr-2018-228529
DP  - 2019 Apr 01
TA  - BMJ Case Reports
PG  - e228529
VI  - 12
IP  - 4
4099  - http://casereports.bmj.com/content/12/4/e228529.short
4100  - http://casereports.bmj.com/content/12/4/e228529.full
SO  - BMJ Case Reports2019 Apr 01; 12
AB  - Myasthenia gravis (MG) is an autoimmune disease where antibodies attack the presynaptic terminals at the neuromuscular junction causing progressive weakness. Associated with thymomas, resection can improve symptoms. A 29-year-old woman with MG who underwent two previous thymectomies, at ages 11 and 15 presented 14 years later with recurrent MG symptoms and an anterior mediastinal mass. Robotic-assisted thoracoscopic excision of the mediastinal mass was performed without complications. She recovered well and had improvement of her MG symptoms. Thymectomy can significantly improve symptoms in MG even for patients who do not have a thymoma. Reports of distant benign thymoma recurrence are rare. MG patients require continued monitoring and vigilance, even after thymectomy. Benign thymomas can recur even after significant time intervals, and utilisation of the robotic platform for recurrent thymoma excision is safe, even following two sternotomies. Patient symptoms improve with redo thymectomy.