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PONM08 Late recurrent thymoma: a case series
  1. J Spillane1,2,
  2. D M Kullmann1,2,
  3. C Taylor1,2,
  4. N P Hirsch1,2
  1. 1DCEE Kullmann Laboratory, London, UK
  2. 2MRC Centre for Neuromuscular Diseases, UCL, Institute of Neurology, London, UK
  1. Correspondence to j.spillane{at}ion.ucl.ac.uk

Abstract

Background In patients with MG, thymoma may recur many years after initial resection.

Aim To describe cases of late recurrent thymoma amongst myasthenic patients in a tertiary referral centre.

Methods Cases of late recurrent thymoma were retrospectively identified and medical notes were reviewed.

Results Five patients with a recurrent thymoma were identified. Four were male. The average age at first tumour presentation was 47.6. Four patients presented with MG. Four had apparent full excision of their thymoma. One patient had invasive disease at first presentation with incomplete resection and adjuvant radiotherapy. The mean disease free interval to recurrence was 13.5 years. Three cases of recurrence were detected on routine scanning whereas the other two patients presented with cough or chest pain. Four patients had repeat surgery. Two patients had palliative radiotherapy and two had chemotherapy. Three patients died. One patient was successfully treated for recurrence but developed sporadic motor neurone disease. One patient remains disease free 3 years after repeat surgery.

Conclusion Thymoma may recur many years after surgery even if the initial tumour has apparently been completely resected. Tumour recurrence may be associated with a poor prognosis. Surveillance scanning after thymoma resection is essential and should continue indefinitely.

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