# Thymoma without Myasthenia Gravis Showing Size Fluctuation in Parallel to Alopecia Areata Activity: A Case Report

## TL;DR

A woman with alopecia areata had a thymoma that changed size with her condition, and her hair loss improved after surgery, suggesting a possible immune link.

## Contribution

Reports a rare case linking alopecia areata and thymoma without myasthenia gravis, suggesting an immunological connection.

## Key findings

- The patient's thymoma size fluctuated in parallel with alopecia areata activity.
- Alopecia areata improved rapidly after thymoma resection and did not recur for 3 years.
- Histopathology confirmed a type B2-dominant thymoma.

## Abstract

Thymomas are commonly associated with autoimmune diseases such as myasthenia gravis (MG), pure red cell aplasia, and hypogammaglobulinemia, while those associated solely with alopecia areata (AA) are extremely rare. A 55-year-old woman with AA underwent chest computed tomography, which revealed a 33-mm anterior mediastinal cystic mass with fluctuating size. She was referred to our department for evaluation of a suspected cystic thymoma. The patient underwent thoracoscopic tumor resection under general anesthesia with isolated lung ventilation in the left lateral decubitus position. The operation lasted 81 minutes with minimal blood loss, and her postoperative course was uneventful. Histopathology confirmed a type B2-dominant thymoma. Notably, the patient’s AA improved rapidly after surgery and did not recur for at least 3 years. This case strongly suggests a potential immunological relationship between AA and thymoma, though further research is needed to confirm this relationship.