Autoimmune alopecia areata due to thymoma without myasthenia gravis: a case report

Abstract Background Thymoma is associated with autoimmune diseases. Myasthenia gravis is frequently associated with thymoma, but cases of thymoma complicated by alopecia areata are very rare. In this report, we present a case of thymoma associated with alopecia areata, but without Myasthenia gravis....

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Main Authors: Yukino Saito, Tomohiro Yazawa, Toshiteru Nagashima, Yoichi Ohtaki, Natsuko Kawatani, Eiji Narusawa, Ryohei Yoshikawa, Nozomi Matsumura, Tatsuro Maehara, Ken Shirabe
Format: Article
Language:English
Published: SpringerOpen 2023-05-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-023-01655-2
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author Yukino Saito
Tomohiro Yazawa
Toshiteru Nagashima
Yoichi Ohtaki
Natsuko Kawatani
Eiji Narusawa
Ryohei Yoshikawa
Nozomi Matsumura
Tatsuro Maehara
Ken Shirabe
author_facet Yukino Saito
Tomohiro Yazawa
Toshiteru Nagashima
Yoichi Ohtaki
Natsuko Kawatani
Eiji Narusawa
Ryohei Yoshikawa
Nozomi Matsumura
Tatsuro Maehara
Ken Shirabe
author_sort Yukino Saito
collection DOAJ
description Abstract Background Thymoma is associated with autoimmune diseases. Myasthenia gravis is frequently associated with thymoma, but cases of thymoma complicated by alopecia areata are very rare. In this report, we present a case of thymoma associated with alopecia areata, but without Myasthenia gravis. Case presentation A 60-year-old woman had a complaint of rapid progression of alopecia areata. A hair follicular biopsy was performed, which showed the infiltration of CD8-positive lymphocytes. She was prescribed topical steroids for 2 months prior to surgery, but her hair loss was not improved. Screening computed tomography showed a mass in the anterior mediastinum, which was suspected to be a thymoma. Myasthenia gravis was ruled out because she had no relevant symptoms or physical findings, and no anti-acetylcholine receptor antibodies were detected in serum. We performed a transsternal extended thymectomy based on a diagnosis of thymoma Masaoka stage I, without myasthenia gravis. Pathological examination showed Type AB thymoma, Masaoka stage II. The chest drainage tube was removed on postoperative day 1, and the patient was discharged on postoperative day 6. The patient has continued topical steroids and showed improvement 2 months postoperatively. Conclusions Although alopecia areata is a rare complication in thymoma cases without myasthenia gravis, thoracic surgeons need to keep this condition in mind because alopecia reduces the patient's quality of life.
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spelling doaj.art-dc469c8095234a0691e06e66229fb6632023-05-07T11:22:03ZengSpringerOpenSurgical Case Reports2198-77932023-05-01911410.1186/s40792-023-01655-2Autoimmune alopecia areata due to thymoma without myasthenia gravis: a case reportYukino Saito0Tomohiro Yazawa1Toshiteru Nagashima2Yoichi Ohtaki3Natsuko Kawatani4Eiji Narusawa5Ryohei Yoshikawa6Nozomi Matsumura7Tatsuro Maehara8Ken Shirabe9Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University HospitalDivision of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University HospitalDivision of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University HospitalDivision of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University HospitalDivision of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University HospitalDivision of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University HospitalDivision of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University HospitalDepartment of Pathology, Gunma University HospitalDepartment of Pathology, Gunma University HospitalDivision of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University HospitalAbstract Background Thymoma is associated with autoimmune diseases. Myasthenia gravis is frequently associated with thymoma, but cases of thymoma complicated by alopecia areata are very rare. In this report, we present a case of thymoma associated with alopecia areata, but without Myasthenia gravis. Case presentation A 60-year-old woman had a complaint of rapid progression of alopecia areata. A hair follicular biopsy was performed, which showed the infiltration of CD8-positive lymphocytes. She was prescribed topical steroids for 2 months prior to surgery, but her hair loss was not improved. Screening computed tomography showed a mass in the anterior mediastinum, which was suspected to be a thymoma. Myasthenia gravis was ruled out because she had no relevant symptoms or physical findings, and no anti-acetylcholine receptor antibodies were detected in serum. We performed a transsternal extended thymectomy based on a diagnosis of thymoma Masaoka stage I, without myasthenia gravis. Pathological examination showed Type AB thymoma, Masaoka stage II. The chest drainage tube was removed on postoperative day 1, and the patient was discharged on postoperative day 6. The patient has continued topical steroids and showed improvement 2 months postoperatively. Conclusions Although alopecia areata is a rare complication in thymoma cases without myasthenia gravis, thoracic surgeons need to keep this condition in mind because alopecia reduces the patient's quality of life.https://doi.org/10.1186/s40792-023-01655-2ThymomaAlopecia areataSurgeryAutoimmune disease
spellingShingle Yukino Saito
Tomohiro Yazawa
Toshiteru Nagashima
Yoichi Ohtaki
Natsuko Kawatani
Eiji Narusawa
Ryohei Yoshikawa
Nozomi Matsumura
Tatsuro Maehara
Ken Shirabe
Autoimmune alopecia areata due to thymoma without myasthenia gravis: a case report
Surgical Case Reports
Thymoma
Alopecia areata
Surgery
Autoimmune disease
title Autoimmune alopecia areata due to thymoma without myasthenia gravis: a case report
title_full Autoimmune alopecia areata due to thymoma without myasthenia gravis: a case report
title_fullStr Autoimmune alopecia areata due to thymoma without myasthenia gravis: a case report
title_full_unstemmed Autoimmune alopecia areata due to thymoma without myasthenia gravis: a case report
title_short Autoimmune alopecia areata due to thymoma without myasthenia gravis: a case report
title_sort autoimmune alopecia areata due to thymoma without myasthenia gravis a case report
topic Thymoma
Alopecia areata
Surgery
Autoimmune disease
url https://doi.org/10.1186/s40792-023-01655-2
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