Question

A 45-year-old patient presents with ptosis and muscle weakness that improves with rest. She also complains of dysphagia and has engorged veins in her thorax. Based on the CT scan image provided, what is the most likely diagnosis? 

• A. Thymoma
• B. Pancoast tumor
• C. Adenocarcinoma
• D. Small cell lung cancer

Hint:

When a patient presents with ptosis, muscle weakness, and dysphagia along with chest imaging abnormalities, consider thymoma as a potential cause, especially in the context of myasthenia gravis.

Answer 1

The Correct Option is A

The patient, a 45-year-old, displays symptoms including ptosis and muscle weakness that improve with rest, dysphagia, and engorged thoracic veins. These clinical manifestations suggest the presence of myasthenia gravis, a common paraneoplastic syndrome. Myasthenia gravis arises due to antibodies targeting acetylcholine receptors, leading to fluctuating muscle weakness.

The improvement of symptoms with rest is characteristic of myasthenia gravis. This condition is frequently associated with a thymoma, a tumor originating from tissue in the thymus.

The engorged veins in the thorax can suggest the presence of superior vena cava (SVC) syndrome, which can occur when the tumor in the anterior mediastinum compresses the SVC.

The CT scan image, although not visible here, would typically reveal a mass in the anterior mediastinum consistent with a thymoma.

Based on the patient's symptoms and the association with myasthenia gravis, the most likely diagnosis is: Thymoma