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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.

Zoom Image
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].


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Conflict of interest:

There is no conflict of interest to declare.

  • 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

Address for correspondence

Paulo Victor Sgobbi de Souza
Departamento de Neurologia e Neurocirurgia da UNIFESP; Rua Estado de Israel Street, 899; 04022-002 São Paulo SP
Brasil   

Publication History

Received: 22 February 2017

Accepted: 11 September 2017

Article published online:
30 August 2023

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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

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Zoom Image
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).