Thymoma associated with fatal myocarditis and polymyositis in a 58-year-old man following treatment with carboplatin and paclitaxel: A case report

Sasaki,Hidefumi; Yano,Motoki; Kawano,Osamu; Hikosaka,Yu; Fujii,Yoshitaka

doi:10.3892/ol.2011.501

February 2012 Volume 3 Issue 2

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

February 2012 Volume 3 Issue 2

Full Size Image

Case Report

Thymoma associated with fatal myocarditis and polymyositis in a 58-year-old man following treatment with carboplatin and paclitaxel: A case report

Authors:
- Hidefumi Sasaki
- Motoki Yano
- Osamu Kawano
- Yu Hikosaka
- Yoshitaka Fujii
View Affiliations / Copyright

Affiliations: Department of Surgery II, Nagoya City University Medical School, Nagoya 467-8601, Japan
Pages: 300-302
|
Published online on: November 30, 2011

https://doi.org/10.3892/ol.2011.501
Expand metrics +

Abstract

We report the case of a 58-year-old male presenting with giant cell myocarditis and myositis associated with thymoma following treatment with carboplatin and paclitaxel. The patient was diagnosed as having stage IVa thymoma. Acetylcholine receptor binding antibody titers were positive at 42 nmol/l, although the patient exhibited no symptoms of myasthenia gravis (MG). The patient was treated with a combination of carboplatin and paclitaxel. However, 18 days following administration of this second cycle of chemotherapy, the patient developed a low-grade fever. Twenty-one days after receiving the second cycle of chemotherapy, the patient was admitted to the Nagoya City University Medical School complaining of general fatigue. Serum levels of creatinine phosphokinase (7,271 U/l), alanine aminotransferase (469 U/l) and aspartate aminotransferase (561 U/l) were elevated. Electromyography revealed no evidence of a neuromuscular junction defect or myopathic process. The patient developed progressive muscle weakness and succumbed to the disease in hospital on day 9. An autopsy revealed thymoma invasion of the left parietal and visceral pleura, pericardium and diaphragm. Numerous skeletal muscle groups and myocardium exhibited diffuse lymphocytic infiltration. Although it has been suggested that myocardial disorders may occur in patients with thymoma and/or MG, the mechanism involved remains unknown. This second report may provide new data regarding giant cell myocarditis and myositis associated with thymoma following treatment with carboplatin and paclitaxel.

View Figures

View References

1	Giordano A and Haymondo J: Myasthenia gravis: a report of two cases with necropsy findings. Am J Clin Pathol. 14:253–265. 1944.
2	Burke JS, Medline NM and Katz A: Giant cell myocarditis and myositis. Associated with thymoma and myasthenia gravis. Arch Pathol. 88:359–366. 1969.PubMed/NCBI
3	Namba T, Brunner NG and Grob D: Idiopathic giant cell polymyositis. Report of a case and review of the syndrome. Arch Neurol. 31:27–30. 1974. View Article : Google Scholar : PubMed/NCBI
4	Gidron A, Quadrini M, Dimov N, et al: Malignant thymoma associated with fatal myocarditis and polymyositis in a 32-year-old woman with a history of hairy cell leukemia. Am J Cin Oncol. 29:213–214. 2006.PubMed/NCBI
5	Masaoka A, Monden Y, Nakahara K, et al: Follow-up study of thymomas with special reference to their clinical stages. Cancer. 48:2485–2492. 1981. View Article : Google Scholar : PubMed/NCBI
6	Kondo K and Monden Y: Therapy for thymic epithelial tumors: a clinical study of 1320 patients from Japan. Ann Thorac Surg. 76:878–885. 2003. View Article : Google Scholar : PubMed/NCBI
7	Venuta F, Rendina EA, Pescarmona EO, et al: Multimodality treatment of thymoma: a prospective study. Ann Thorac Surg. 64:1585–1592. 1997. View Article : Google Scholar : PubMed/NCBI
8	Tanahashi N, Sato H, Nogawa S, et al: A case report of giant cell myocarditis and myositis observed during the clinical course of invasive thymoma associated with myasthenia gravis. Keio J Med. 53:30–42. 2004.PubMed/NCBI
9	Ko KF, Ho T and Chan KW: Autoimmune chronic active hepatitis and polymyositis in a patient with myasthenia gravis and thymoma. J Neurol Neurosurg Psychiatry. 59:558–559. 1995. View Article : Google Scholar : PubMed/NCBI
10	Wakafuji S and Okada R: Twenty year autopsy statistics of myocarditis incidence in Japan. Jpn Circ J. 50:1288–1293. 1986.PubMed/NCBI
11	Glennon PE, Petersen ME and Sheppard MN: Fatal giant cell myocarditis after resection of thymoma. Heart. 75:531–532. 1996. View Article : Google Scholar : PubMed/NCBI
12	Davies MJ, Pomerance A and Teare RD: Idiopathic giant cell myocarditis - a distinctive clinoco-pathological entity. Br Heart J. 37:192–195. 1975. View Article : Google Scholar : PubMed/NCBI
13	Ren H, Poston RS, Hruban RH, et al: Long survival with giant cell myocarditis. Mod Pathol. 6:402–407. 1993.PubMed/NCBI
14	Desjardins V, Pelletier G, Leung TL and Waters D: Successful treatment of severe heart failure caused by idiopathic giant cell myocarditis. Can J Cardiol. 8:788–792. 1992.PubMed/NCBI
15	Roberts WC, Kehoe JA, Carpenter DF, et al: Cardiac valvular lesions in rheumatoid arthritis. Arch Intern Med. 122:141–146. 1968. View Article : Google Scholar : PubMed/NCBI
16	Humbert P, Faivre R, Fellman D, et al: Giant cell myocarditis: an autoimmune disease? Am Heart J. 115:485–487. 1988. View Article : Google Scholar : PubMed/NCBI
17	Reingold IM: Myocardial lesions in disseminated coccidioidomycosis. Am J Clin Pathol. 20:1044–1049. 1950.PubMed/NCBI
18	Buchibinder NA and Robert WC: Left-sided valvular active infective endocarditis: a study of forty-five necropsy patients. Am J Med. 53:20–35. 1972. View Article : Google Scholar : PubMed/NCBI
19	Suzuki H, Mizuno Y, Kurita T, et al: Rare type myositis and myocarditis revealed in myasthenia gravis with malignant thymoma. Saishin-igaku (in Japanese). 31:2417–2424. 1976.
20	Tomimoto H, Akiguchi I, Kameyama M, et al: Giant cell myositis and myocarditis associated with myasthenia gravis and thymoma-an autopsy case. Rinsho Shinkeigaku (in Japanese). 25:688–693. 1985.PubMed/NCBI
21	Zhang S, Kodama M, Hanawa H, et al: Effects of cyclosporine, predonisolone and aspirin on rat autoimmune giant cell myocarditis. J Am Coll Cardiol. 21:1254–1260. 1993. View Article : Google Scholar : PubMed/NCBI
22	Kong G, Madden B, Spyrou N, et al: Response of recurrent giant cell myocarditis in a transplanted heart to intensive immunosuppression. Eur Heart J. 12:554–557. 1991.PubMed/NCBI
23	Gries W, Farkas D, Winters GL, et al: Giant cell myocarditis: first report of disease recurrence in the transplanted heart. J Heart Lung Transplant. 11:370–374. 1992.PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Thymoma associated with fatal myocarditis and polymyositis in a 58-year-old man following treatment with carboplatin and paclitaxel: A case report

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Related Articles