Rare paraneoplastic syndromes associated with thymoma: case reports and literature review

Thymoma is the most common anterior mediastinal tumor, which is linked to the loss of self-tolerance and the presence of autoimmunity. Various interactions between thymoma and autoimmune diseases have been identified, including myasthenia gravis, systemic lupus erythematosus, pure red cell aplasia, and pemphigus. In this retrospective case series, we reported rare autoimmune disorders with different organ involvement associated with thymoma. These included ocular paraneoplastic pemphigus, neuromyelitis optica spectrum disorder, diffuse panbronchiolitis and myositis. Our series broadens the spectrum of autoimmune disorders with shared T cell-mediated and B cell-dependent pathogenesis, underscoring the recurrence or relapse of thymoma-associated autoimmunity. The recognition of rare autoimmune presentations charts future treatment decisions and multidisciplinary care.