Thymoma-associated myasthenia gravis: Clinical features and surgical results

• Published in: Revue neurologique 2013-11, Vol.169 (11), p.879-883
• Main Authors: Bouchikh, M, El Malki, H O, Ouchen, F, Achir, A, Benosman, A
• Format: Article
• Language: fre
• Subjects: Adult; Female; Humans; Male; Middle Aged; Myasthenia Gravis - epidemiology; Myasthenia Gravis - etiology; Myasthenia Gravis - surgery; Retrospective Studies; Sternotomy - statistics & numerical data; Thoracotomy - statistics & numerical data; Thymectomy - methods; Thymectomy - statistics & numerical data; Thymoma - complications; Thymoma - epidemiology; Thymoma - surgery; Thymus Neoplasms - complications; Thymus Neoplasms - epidemiology; Thymus Neoplasms - surgery; Treatment Outcome
• ISSN: 0035-3787
• DOI: 10.1016/j.neurol.2013.01.625

The aim of this study was to compare the characteristics of myasthenic patients with and without thymoma, and the results of thymectomy in both types of patients. A retrospective study was conducted among 66 patients who underwent thymectomy for myasthenia gravis in our department over a 10-year period (2000-2010). The surgical approach was sternotomy or anterolateral thoracotomy. Patients were divided into two groups according to the presence of thymoma: with (T-MG) and without (NT-MG) thymoma. Complete stable remission (CSR) was the primary endpoint. Median age was 35.09±9.89 years. The NT-MG group had 38 patients (57.57%) and the T-MG group 28 patients (42.43%). There was no difference between the two groups regarding the surgical approach (P=0.52). T-MG patients were older (40.54±15.16 vs. 31.37±9.46) (P=0.008) and predominantly male. There were more generalized forms (P=0.01) and more bulbar involvement (P=0.02) in the T-MG group. The rate of CSR at 5 years was 7% and 17% in the T-MG and NT-MG patients respectively (P=0.70). At 10 years, it was 36% and 94.73% respectively (P=0.03). Thymomatous myasthenia gravis is characterized by the severity of its clinical features. Remission rate at 10 years was significantly lower in the myasthenia with thymoma group.