Objective:

To report a case of de novo stage IVA thymoma with concurrent autoimmune diseases (myasthenia gravis and systemic lupus erythematosus) and the role of neoadjuvant chemotherapy in enabling surgical resection.

Approach:

• Case Presentation: A 32-year-old woman with SLE presented with symptoms of MG. Imaging revealed a large anterior mediastinal mass, and a biopsy confirmed thymoma. She underwent neoadjuvant chemotherapy followed by surgical resection.

Key Findings:

• Neoadjuvant chemotherapy led to significant clinical improvement and marked radiographic tumor regression.
• The patient underwent successful surgical resection with negative margins and received postoperative radiotherapy.
• At follow-up, the patient had complete resolution of MG symptoms and no evidence of recurrent disease.

Interpretation:

This case illustrates the challenges in managing advanced thymoma with concurrent autoimmune diseases and describes the role of neoadjuvant chemotherapy in facilitating surgical resection.

Limitations:

• There is limited prospective data on the optimal management of advanced thymoma.
• This case study is based on a single patient, which may not generalize to broader populations.

Conclusion:

This case highlights the management of advanced thymoma in the context of concurrent autoimmune diseases.