ITP, Early Presentation of Thymoma

Abstract

Mediastinal neoplasms are uncommon tumors that can occur at any age but are most common through the fifth decades of life.
A wide variety of systemic disorders are associated with 71% of thymomas. The symptoms of these as¬sociated disorders often lead to the original discovery of the mediastinal tumor. A 35-year-old female with petechia and purpura was admitted to Sina hospital of the city of Hamadan in 5/6/2000. the serum platelet count was 4000/microliter. After the primary evaluations Idiopathic Thrombocytopenic Purpura (ITP) was diagnosed and after corticosteroid therapy serum platelet count increased. After 2 month she was admitted to the neurology ward of our hospital with diagnosis of cerebro vascular accident (CVA). In brain computed tomography (CT) scan a hyperdense lesion was reported that reveald hemorrhage in the temporoparietal region. The platelet count was 154000/microliter at this time which suggests the idea that some suppressive antibodies in the serum might lead to platelet disfunction. Two years later she was admitted to Shariati hospital with fatigue, left lid ptosis, speech disorder, bifacial weakness, diplopia and muscle force = 4/5. Myasthenia gravis was diagnosed and in the chest CT scan a density associated with thymus was reported. Thymectomy was performed for the patient and report of the pathologist was thymoma. After adjuvant radiotherapy serum platelet count increased and myasthenia gravis was improved and all of the patient's signs and symptoms resolved. ITP must be considered as one of the paraneoplastic symptoms of thymoma.