Five-Year Follow-up of a Case of Radical Robotic Excision of Clear Cell Thymic Carcinoma Associated with Thymoma and Myasthenia Gravis

Clear cell carcinoma is a variant of thymic epithelial malignant tumors that is rarely associated with paraneoplastic syndrome, like myasthenia gravis, or thymoma. Thymic carcinoma (TC) is often asymptomatic and unresectable or metastatic at presentation, so the prognosis is poor also due to the lack of standardized multimodality treatments. We report a successful case of a robot-assisted radical thymectomy in a 63-year-old man affected by stage V myasthenia gravis who presented generalized weakness and respiratory failure, treated by mechanical ventilation and tracheostomy. The post-operative course was uneventful. The final pathological examination showed the presence of two distinct lesions: a type B3 Masaoka-Koga stage I thymoma and a clear cell carcinoma completely encapsulated. The patient is alive without recurrence and partial remission of the myasthenia after radical thymectomy.