A 54-year-old male with unexplained nonischemic cardiomyopathy was diagnosed with a WHO type B thymoma in the absence of myasthenia gravis, expanding the paraneoplastic phenotype.
Case Report (n=1)
This case report highlights the need for heightened clinical suspicion of thymoma-associated cardiomyopathy even in the absence of myasthenia gravis.
ABSTRACT Thymomas are rare epithelial tumors of the anterior mediastinum known for their association with autoimmune and paraneoplastic syndromes, most notably myasthenia gravis (MG). Cardiomyopathy is an exceptionally rare paraneoplastic manifestation. Emerging case reports suggest that thymoma may exert systemic effects independent of MG, including direct or immune‐mediated myocardial injury. We report the case of a 54‐year‐old male with known nonischemic cardiomyopathy who presented with septic shock from pneumonia and cholecystitis, complicated by ventricular arrhythmias and decompensated heart failure. Imaging revealed a calcified anterior mediastinal mass, later diagnosed as a World Health Organization (WHO) type B thymoma. Notably, the patient lacked any clinical or serologic evidence of MG or other autoimmune syndromes. Cardiac magnetic resonance imaging (MRI) excluded myocarditis and takotsubo cardiomyopathy, while coronary angiography ruled out ischemic disease. Despite anticoagulation, a persistent left ventricular (LV) thrombus remained. The patient's cardiac dysfunction necessitated mechanical ventilation, vasopressors, and a multidisciplinary heart failure regimen. This case expands the phenotype of thymoma beyond the traditional paraneoplastic spectrum. It reinforces the need for heightened clinical suspicion and a multisystem diagnostic approach in cases of unexplained cardiomyopathy. Further investigation into immune‐mediated cardiac injury in thymoma is warranted.
Barman et al. (Mon,) conducted a case report in Nonischemic cardiomyopathy and thymoma (n=1). Thymoma was evaluated. A 54-year-old male with unexplained nonischemic cardiomyopathy was diagnosed with a WHO type B thymoma in the absence of myasthenia gravis, expanding the paraneoplastic phenotype.