Association between thymoma and persistent hypothermia: a case report
Association between thymoma and persistent hypothermia: a case report
Introduction: Thymomas are rare, slow-growing tumours that present in a variety of ways such as incidental findings on chest radiographs following symptoms of cough and dyspnoea. Thymomas ay also present with symptoms due to intrathoracic spread such as superior vena cava obstruction, or with symptoms of an associated paraneoplastic disorder. Such paraneoplastic disorders are typified by the generation of autoantibodies directed against a variety of self antigens including myasthenia gravis, neuromyotonia, and hypogammaglobulinaemia. Significant hypothermia in association with thymoma has been described previously in one published case report. The basis for hypothermia in that case was not clear, but was postulated to elate to abnormal central thermal regulation and was resolved completely following treatment with intravenous gammablobulin, thus suggesting an autoimmune aetiology.
Case presentation: We present the case of an 88-year-old man with Type A thymoma and persistent hypothermia. An extensive investigation of the hypothermia revealed no aetiology other than the thymoma itself. Symptoms of hypothermia were treated effectively with passive and active external rewarming. The patient's dyspnoea was much improved by intercostal drainage of a leftsided pleural effusion and talc pleurodesis. He was not offered definitive treatment for the hymoma in view of its relatively favourable prognosis, and because his symptoms were well controlled at the time of discharge.
Conclusion: We suggest that the possibility of thymoma be investigated once the more common auses of hypothermia have been excluded in an appropriate clinical context. To the best of our knowledge, this is only the second published case report describing such an association.
Disclosure: © 2009 Johns and Reinhardt; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 12 October 2009 Accepted: 12 October 2009
Correspondence:Robin H Johns, Chest Clinic, Whipps Cross University Hospital NHS Trust, London E11 1NR, UK
Journal of Medical Case Reports 2009, 3:73 doi:10.1186/1752-1947-3-73
This article is available from: http://www.jmedicalcasereports.com/content/3/1/73
Introduction
The thymus is a small anterosuperior mediastinal organ involved in the processing and maturation of T lymphocytes. The thymus gland grows from birth until puberty, when it reaches a maximum weight of approximately 0 grams. It subsequently atrophies but persists in an atrophic state into old age.
Thymomas are the most common neoplasm to affect the thymus gland, with an incidence of 0.15 per 100,000. The probability of developing the condition increases as one reaches the eighth decade of life and is more pronounced in men 1.
