Thymic Neoplasms and Myasthenia Gravis

Thymic Neoplasms and Myasthenia Gravis Symptoms and Diagnosis

Symptoms of thymic neoplasms

Frequently, thymic neoplasms do not cause any recognizable symptoms. A doctor may discover the cancer during a routine chest x-ray.

If you experience any of the following symptoms, consult your doctor. A number of conditions could cause these symptoms and they aren’t necessarily indicative of thymic neoplasms.

• Persistent, chronic cough
• Chest pain
• Difficulty breathing

Diagnosing thymic neoplasms

The health care team in UPMC's Division of Thoracic and Foregut Surgery may use one of the following tests or procedures to detect and identify a thymoma or thymic carcinoma:

• Physical exam — your doctor will conduct a thorough exam to check for signs of disease or anything that appears unusual. He or she will likely take a history of your health habits, past illnesses, and treatments.
• Chest x-ray — uses radiation to take pictures of the bones and organs inside your chest.
• CT scan — uses a computer to take a series of detailed pictures of certain areas inside your body from several different angles. You may need to have dye injected into a vein or take it orally to make the organs and tissues inside show up more clearly.
• Magnetic resonance imaging (MRI) — uses a powerful magnet, radio waves, and a computer to take a series of pictures of areas inside the body.
• Positron emission tomography scan (PET scan) — requires that you have a small amount of radioactive glucose injected into your vein. The PET scanning device rotates around your body, taking pictures. Cancer cells show up as bright spots in the picture because they take up more glucose than normal cells do.

Symptoms of myasthenia gravis

The primary sign that a person may have myasthenia gravis is muscle weakness that diminishes upon resting.

Common symptoms include:

• Drooping eyelids — one or both eyes
• Double vision
• Difficulty swallowing
• Choking easily during eating
• Difficulty chewing because of muscle fatigue
• Fewer than normal facial expressions
• Altered speech — soft or nasal sounding speech
• Weakness in neck or arms

Diagnosing myasthenia gravis

Your doctor may conduct one or more tests to confirm a diagnosis of myasthenia gravis:

• Edrophonium test — injection of the chemical edrophonium. If this results in a sudden, yet temporary, improvement in muscle strength and stamina, it’s a good indicator that you may have myasthenia gravis.
• Blood panel — to check for certain abnormal antibodies.
• Repetitive nerve stimulation — to test how muscles respond to nerve stimulation.
• Single-fiber electromyography (EMG) — to check the health of the muscles and the nerves that control the muscles.
• Imaging scans — CT scan or MRI to check for abnormal size or appearance of the thymus gland.

Contact Us

Contact the UPMC Esophageal and Lung Surgery Institute with questions or for more information.
Or, call the Thoracic and Foregut Surgery Division at 412-647-7555.

Thymic Neoplasms and Myasthenia Gravis Treatment

Thymectomy surgery for thymic tumors and myasthenia gravis

If you have a thymic tumor, with or without myasthenia gravis, you will need to undergo surgery — called a thymectomy — to remove your thymus gland. Even if you don’t have a thymic neoplasm, your doctor may advise you to undergo a thymectomy for myasthenia gravis.

Many health care facilities offer only open chest surgery for thymectomy procedures. Thoracic surgeons at the UPMC Esophageal and Lung Surgery Institute perform both minimally invasive and robotic-assisted thymectomies, in addition to traditional open chest surgery.

During a thymectomy, your surgeon will remove the affected part of the thymus or the entire thymus gland.

Even if the surgeon removes the entire thymic tumor or performs a thymectomy, he may also order radiation therapy after surgery to make sure no more cancer cells develop. This will lower your risk of the cancer returning.

Other adjuvant therapies for thymic neoplasms may include chemotherapy and hormone therapy.

Non-surgical interventions for myasthenia gravis

For mild cases of myasthenia gravis — or for people over 60 years of age — doctors can use the following non-surgical treatments to relieve symptoms:

• Cholinesterase inhibitors
• Corticosteroids
• Immunosuppressants
• Plasmapheresis
• Intravenous immunoglobulin

Contact Us

Contact the UPMC Esophageal and Lung Surgery Institute with questions or for more information.
Or, call the Thoracic and Foregut Surgery Division at 412-647-7555.