Pruritus as a Paraneoplastic Symptom of Thymoma.
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
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.
Padda SK, Shrager JB, Riess JW, Pagtama JY, Holmes Tisch AJ, Kwong BY, Liang Y, Schwartz EJ, Loo BW, Neal JW, Hardy R, Wakelee HA. Pruritus as a Paraneoplastic Symptom of Thymoma. J Thorac Oncol. 2015 Nov;10(11):e110-2. doi: 10.1097/JTO.0000000000000623. PMID: 26536199; PMCID: PMC4720251.