ABSTRACT
A 45-year-old-man presented with severe vomiting, constipation, abdominal distention and bilateral ocular abductor palsy. Evaluation revealed diffuse autonomic dysfunction characterized by intestinal pseudo-obstruction, xerophthalmia, xerostomia, postural hypotension, erectile dysfunction and loss of sinus arrhythmia. Paraneoplastic work-up revealed thymoma. Most symptoms resolved after surgical removal of the thymoma. Six weeks later he developed worsening of external ophthalmoparesis with ptosis, responding to acetylcholinesterase inhibitor, confirming myasthenia gravis.
Subject(s)
Cholinesterase Inhibitors/therapeutic use , Humans , Intestinal Pseudo-Obstruction/diagnosis , Male , Middle Aged , Myasthenia Gravis/complications , Pyridostigmine Bromide/therapeutic use , Thymectomy , Thymoma/complications , Thymus Neoplasms/complications , Treatment OutcomeABSTRACT
A 27-year-old man presented with 2 months' history of right hypochondrial pain, fever and mild transient pruritus. On examination, he had firm, nontender and nodular hepatomegaly. Imaging modalities showed multiple heterogeneous lesions of varying size in the liver. Liver biopsy was consistent with hepatocellular adenoma.