Extrathymic malignancies in patients with myasthenia gravis

Netta Levin, Oded Abramsky, Alexander Lossos, Dimitrios Karussis, Tali Siegal, Zohar Argov, Tamir Ben Hur*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Introduction: Myasthenia gravis (MG) is considered a paraneoplastic phenomenon of thymomas in 15% of patients. Co-existence of MG with extrathymic malignancies, and an increased risk of second malignancy in patients with thymoma have been reported. Data on clinical characteristics of MG patients with extrathymic malignancies and the role of concomitant diseases and their treatment are lacking. Methods: The clinical records of 188 consecutive MG patients were studied retrospectively. We examined whether gender, age, generalized disease, seropositivity for acetyl-choline receptor antibodies, occurrence of thymoma, immunosuppressive therapy and occurrence of other autoimmune diseases determined an increased risk for development of extrathymic malignancy. Results: This group followed the typical epidemiological characteristics of MG. Thirty-three patients (17.6%) had a thymoma. Twenty-nine patients (15.4%) had 30 extrathymic malignant tumors of various origins. Only four patients with extrathymic tumors had an associated thymoma. Tumors were diagnosed between 20 years prior to and 35 years after the appearance of MG. Older age of MG onset was the only risk factor identified for development of malignancy in MG. Discussion: Extrathymic malignancies are common in MG patients, especially in the older age group. There are no specific clinical features of the subgroup of MG patients with cancer. Although MG is not a paraneoplastic phenomenon of extrathymic malignancy, the association between MG and malignancy may be due to a common background of immune dysregulation.

Original languageAmerican English
Pages (from-to)39-43
Number of pages5
JournalJournal of the Neurological Sciences
Issue number1-2
StatePublished - 15 Oct 2005
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported in part by The Hilda Katz Blaustein and in part by the Lena P. Harvey Fund.


  • Autoimmune disease
  • Azathioprine
  • Cancer
  • Myasthenia gravis
  • Thymoma


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