Malignant thymoma with dysautonomia and disordered neuromuscular transmission
M. A. Tabbaa, R. T. Leshner and W. W. Campbell
A 42-year-old man had prominent dysautonomia accompanied by clinical and
electrophysiological features of both myasthenia gravis and the
Lambert-Eaton myasthenic syndrome. Antiacetylcholine receptor antibodies
were present in high titer. Invasive thymoma was found at thymectomy;
later, a solitary metastasis to the spleen required a splenectomy. Complete
remission followed surgery. There was evidence of antibody activity
directed against postsynaptic acetylcholine receptors, presynaptic somatic
motor terminals, and autonomic effector junctions. To our knowledge, the
association of thymoma with a myasthenia gravis-Lambert-Eaton overlap
syndrome has not been reported previously.
