Pruritus as a Paraneoplastic Symptom of Thymoma.

Document Type

Article

Publication Date

11-2015

Publication Title

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer

Abstract

We describe the first cases in the literature, to our knowledge, of pruritus as a paraneoplastic symptom of thymoma. The first case is a 36-year-old woman who developed significant generalized pruritus without rash during her second pregnancy, which did not resolve after delivery and which was recalcitrant to topical steroids, antihistamines, and dry skin care. An extensive pruritus laboratory workup was performed and was negative (Table 1). A chest computed tomography (CT) performed 14 months after the onset of pruritus demonstrated a 7.5×4.3 cm anterior mediastinal mass that infiltrated the mediastinal fat and abutted the great vessels (Fig. 1A and B; Table 2). CT-guided fine needle aspiration of the mass and a repeat core biopsy was nondiagnostic but consistent with thymic sampling. Immunohistochemistry for Hodgkin’s disease (HD) was negative. Based on the very high clinical suspicion of thymoma, she underwent three cycles of neoadjuvant cisplatin, cyclophosphamide, and doxorubicin chemotherapy with good response. Her pruritus resolved 3 days after her first cycle. She had a complete thymectomy, and final pathology demonstrated a Masaoka-Koga stage II World Health Organization type B2 thymoma. The patient is undergoing surveillance, without recurrence of disease or pruritus, now 2 years postoperatively.

Volume

10

Issue

11

First Page

e110

Last Page

e112

DOI

10.1097/JTO.0000000000000623

ISSN

1556-1380

PubMed ID

26536199

Link to Full Text

Share

COinS