{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T17:39:24Z","timestamp":1758476364109},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,1,4]],"date-time":"2017-01-04T00:00:00Z","timestamp":1483488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:italic>Introduction:<\/jats:italic> We describe an unusual case of pleural drop metastases 21 years after complete resection of an encapsulated thymoma in a Southeast Asian patient with myasthenia gravis (MG). <jats:italic>Methods:<\/jats:italic> This investigation includes a case report and brief review of the literature. <jats:italic>Results:<\/jats:italic> The patient presented in 2015 with generalized weakness, fatigue, and shortness of breath, but no diplopia, ptosis, dysphagia, or dysarthria. Because these symptoms were atypical for an MG exacerbation, a <jats:italic>de\u2010novo<\/jats:italic> work\u2010up was performed. Chest computed tomography (CT) showed numerous pleural nodules (\u201cdrop metastases\u201d), and CT\u2010guided biopsy revealed metastatic thymoma. <jats:italic>Conclusions:<\/jats:italic> The average disease\u2010free interval for thymoma ranges from 68 to 86 months. Pleural and mediastinal recurrence are more common than distant hematogenous recurrence. Adverse prognostic factors include an initial higher Masaoka stage, incomplete resection, older age, and pleural or pericardial involvement. Despite apparent complete resection of thymoma, clinicians should remain vigilant for recurrence for as long as 20 years after initial management. Long\u2010term follow\u2010up with radiologic surveillance is recommended. <jats:italic>Muscle Nerve<\/jats:italic> <jats:bold>56<\/jats:bold>: 171\u2013175, 2017<\/jats:p>","DOI":"10.1002\/mus.25479","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T19:41:19Z","timestamp":1479325279000},"page":"171-175","source":"Crossref","is-referenced-by-count":1,"title":["Pleural \u201cdrop metastases\u201d 21 years after resection of a thymoma"],"prefix":"10.1002","volume":"56","author":[{"given":"Chia\u2010Chun","family":"Chiang","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic Scottsdale Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela M.","family":"Parsons","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Scottsdale Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Scott","family":"Kriegshauser","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harshita R.","family":"Paripati","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology Mayo Clinic Scottsdale Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew A.","family":"Zarka","sequence":"additional","affiliation":[{"name":"Department of Pathology Mayo Clinic Scottsdale Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Arturo","family":"Leis","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Scottsdale Arizona USA"},{"name":"Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center 1350 E. Woodrow Wilson Drive Jackson Mississippi 39216 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,1,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-302865"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-8-340"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-60157-6_3"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19811201)48:11<2485::AID-CNCR2820481123>3.0.CO;2-R"},{"key":"e_1_2_5_6_1","unstructured":"MeneshianA GiacconeG OlivierKR.Clinical presentation and management of thymoma and thymic carcinoma.2016. UpToDate.http:\/\/www.uptodate.com\/. 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