Pure red cell aplasia after resection for thymoma with myasthenia gravis

A 73 year-old woman was diagnosed as thymoma with myasthenia gravis (MG) [ocular type] 18 years ago, but she rejected surgical treatment. The remission of myasthenia gravis has been obtained by treatment of medication. This time, to avoid myasthenic crisis at the time of orthopedic surgery, she underwent surgical treatment for thymoma: extended-thymectomy, resection of the left brachiocephalic vein and reconstraction using ringed polytetrafluoroethylene (ePTFE) graft. Pathologic diagnosis was Masaoka stage III thymoma and World Health Organization (WHO) type B2 + B3. After orthopedic surgery, irradiation was performed for mediastinum. During this period from the resection of thymoma to irradiation, she developed gradually progressive anemia, and as a result of bone marrow examination, she was diagnosed as pure red cell aplasia (PRCA). PRCA has improved with immunosuppressive treatment. One year have passed with no recurrence of thymoma and PRCA.