Simultaneous presentation of myasthenia gravis and mesothelioma

Our plain-English summary of Simultaneous presentation of myasthenia gravis and mesothelioma, by D.J. Thomson, A. Soni, M. Ward, et al (Journal of the Royal Society of Medicine, 2006).

The study

• Authors: D.J. Thomson, A. Soni, M. Ward, H.W. Jones
• Journal: Journal of the Royal Society of Medicine
• Published: 2006;99(5):259-60
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This case report, from the John Radcliffe Hospital in Oxford, UK, described a previously healthy 71-year-old man. He came to hospital with a six-week history of a drooping left upper eyelid, slurred and nasal speech, and difficulty chewing and swallowing. He was a life-long non-smoker and a retired brick-layer and car factory worker. The article did not mention asbestos or any fiber exposure. Doctors diagnosed myasthenia gravis, a disorder that causes muscle weakness. Antibody tests confirmed it, nerve studies supported it, and he responded well to treatment. A chest X-ray showed multiple right-sided pleural masses and a small pleural effusion. A biopsy of one mass showed sarcomatoid mesothelioma. A CT scan showed no thymus tissue in the anterior mediastinum (the front of the chest), and there was no evidence of cancer elsewhere. The authors concluded that this was the first reported case of myasthenia gravis and pleural mesothelioma presenting together. They suggested that if this was a paraneoplastic occurrence (one caused by the cancer), further cases should arise with the expected increase in mesothelioma. The report describes a single patient.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One man aged 71, previously in good health, seen by the Department of General Medicine, John Radcliffe Hospital, Oxford, UK
• Exposure: Occupational history only: life-long non-smoker, retired brick-layer and car factory worker. The article does not mention asbestos, fiber type or dose.
• Main results:
  • The patient was diagnosed with myasthenia gravis with a predominant bulbar presentation. The diagnosis was confirmed by anti-acetylcholine receptor antibodies, with supportive neurophysiological findings.
  • He responded well to anti-cholinesterase and steroid treatment.
  • A chest X-ray showed multiple right-sided pleural masses and a small pleural effusion.
  • On CT of the thorax, no thymic tissue was seen within the anterior mediastinum.
  • Biopsy of one pleural mass gave a histological diagnosis of sarcomatoid mesothelioma, with no evidence of malignancy elsewhere.
• The authors' conclusion: The authors described this as the first reported co-presentation of myasthenia gravis and pleural mesothelioma. They stated that if this is a paraneoplastic occurrence, or more than chance, further cases should arise with the expected increase in mesothelioma incidence.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

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