Thymoma with Granulomatous Myositis, Pure Red Cell Aplasia, and Hepatosplenomegaly: A Case Report and Review Literature
Krittiya Korphaisarn MD*1, Tanawan Apibunyopas MD*2, Chattree Hantaweepant MD*3, Tumtip Sangruchi MD*4, Varalak Srinonprasert MD*5, Praveena Chiowchanwisawakit MD*6
Affiliation : *1 Division of Medical Oncology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *2 Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *3 Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *4 Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *5 Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *6 Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Thymoma is well-recognized as being associated with various autoimmune diseases. Thymoma associated
with granulomatous myositis (GM) is rare and thymoma associated with pure red cell aplasia (PRCA) is somewhat more
frequent. However, coexistence of GM and PRCA in a thymoma patient is extremely uncommon.
Case Report : Here, we present the case of a 40-year-old Thai male who presented with progressive proximal muscle weakness
with dysphagia, anemia, hepatosplenomegaly, and an anterior mediastinal mass. After a thorough investigation, the patient
was diagnosed with stage I type AB thymoma with GM and PRCA. Following treatment with thymectomy, corticosteroids,
and immunosuppressive agents, muscle weakness improved, hepatosplenomegaly resolved, and laboratory abnormalities
normalized. The patient was then able to resume his normal daily activities and return to work.
Conclusion : In this case, we report a rare association of GM, PRCA, hepatosplenomegaly, and thymoma. Early detection
with prompt treatment with tumor removal and immunosuppressive medications resulted in a good clinical response. Based
on our review of the literature, this is the first published case report to describe this combination of coexisting conditions.
Keywords : Thymoma, Granulomatous myositis, Pure red cell aplasia, Hepatosplenomegaly, Paraneoplastic syndrome
