Abstract
IntroductionThymomas 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 may 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 relate to abnormal central thermal regulation and was resolved completely following treatment with intravenous gammablobulin, thus suggesting an autoimmune aetiology.Case presentationWe 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 left-sided pleural effusion and talc pleurodesis. He was not offered definitive treatment for the thymoma in view of its relatively favourable prognosis, and because his symptoms were well controlled at the time of discharge.ConclusionWe suggest that the possibility of thymoma be investigated once the more common causes 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.
Highlights
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
Case presentation: We present the case of an 88-year-old man with Type A thymoma and persistent hypothermia
We suggest that the possibility of thymoma be investigated once the more common causes of hypothermia have been excluded in an appropriate clinical context
Summary
We propose that hypothermia might occur as a paraneoplastic phenomenon in the context of thymoma. We would obviously advocate careful and thorough exclusion of the more common causes of hypothermia, such as sepsis, prior to reaching this conclusion, as failure to treat these could have dire consequences. 7. Ho WK, Wilson JD: Hypothermia, hyperhidrosis, myokymia and increased urinary excretion of catecholamines associated with a thymoma. 8. Nakazono T, Yamaguchi K, Egashira R, Satoh T, Yamasaki F, Mitsuoka M, Hayashi S, Kudo S: Magnetic resonance imaging features of spontaneously regressed thymoma: report of 2 cases. 9. Wong WW, Lane RJ: Transient myasthenia gravis in an elderly woman. CRP: C-reactive protein; CT: computed tomography; PSA: prostate-specific antigen; WHO: World Health Organisation
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