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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(01): 62
DOI: 10.1590/0004-282X20170168
IMAGES IN NEUROLOGY

Rapidly progressive subacute motor neuronopathy disclosing type B2 thymoma

Neuronopatia motora subaguda rapidamente progressiva associada com timoma tipo B2
Paulo Victor Sgobbi de Souza
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Divisão de Doenças Neuromusculares, São Paulo SP, Brasil.
,
Thiago Bortholin
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Divisão de Doenças Neuromusculares, São Paulo SP, Brasil.
,
Wladimir Bocca Vieira de Rezende Pinto
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Divisão de Doenças Neuromusculares, São Paulo SP, Brasil.
,
Acary Souza Bulle Oliveira
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Divisão de Doenças Neuromusculares, São Paulo SP, Brasil.
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A 73-year-old man presented with a three-month history of muscle wasting, cramps and marked weight loss. Examination revealed severe global amyotrophy ([Figure]), fasciculations, reduced deep tendon reflexes and flaccid quadriparesis. Nerve conduction studies were unremarkable. Needle electromyography showed acute and chronic partial denervation in the cervical, thoracic and lumbosacral segments. A full-body CT scan disclosed a large mass in the anterior mediastinum, which showed a type B2 thymoma.

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Figure Findings in subacute motor neuronopathy. Severe muscle wasting in proximal (A) and distal muscle groups (B; black arrow). (C) Rarefaction of interference patterns in submaximal voluntary contraction, and fibrillation and positive sharp wave at rest. (D) Chest CT scan showed a large mass in the anterior mediastinum (white arrow).

Paraneoplastic neuropathies represent an expanding group of immune-mediated neuropathies associated with a known or unidentified neoplasm[1]. Pure motor neuropathy is represented by subacute motor neuronopathy[1], commonly associated with Hodgkin’s and non-Hodgkin’s lymphoma[1],[2] and, rarely, with thymoma[2].



Publication History

Received: 22 February 2017

Accepted: 11 September 2017

Article published online:
30 August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Graus F, Dalmau J. Paraneoplastic neuropathies. Curr Opin Neurol. 2013;26(5):489-95. https://doi.org/10.1097/WCO.0b013e328364c020
  • 2 Stoll DB, Lublin F, Brodovsky H, Laucius JF, Patchefsky A, Cooper H. Association of subacute motor neuronopathy with thymoma. Cancer. 1984;54(4):770-2. https://doi.org/10.1002/1097-0142(1984)54:4<770::AID-CNCR2820540430>3.0.CO;2-E