EFFECT OF ACTH ON THYMIC MASSES

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Abstract
IN A previous paper published in 1948 (1) we reported on the effect of ACTH in a patient with myasthenia gravis and a thymic tumor. This initial study was conducted during the early days of ACTH therapy when the hormone was available in only limited amounts. The patient was treated with 40 mg. of ACTH daily for a period of four days, and treatment was followed by an appreciable decrease in the size of the thymic mass and a subsequent improvement in the myasthenic symptoms. Since this report was published, the salutary effect of ACTH on patients with myasthenia gravis without thymic enlargement has been confirmed elsewhere (2). However, Shy and his coworkers (3) have failed to observe either shrinkage of a thymic neoplasm or improvement in the symptoms of myasthenia gravis in 1 patient treated with cortisone. The present communication is concerned with the influence of ACTH on the size of the thymic mass in 4 additional patients. Three of this group had myasthenia gravis. In 2 patients the thymic enlargement was proven to be due to tumor, which in 1 instance was malignant in character with pleural metastases. In the remaining 2 patients the thymic enlargement was demonstrated by roentgenologic study, but neither operative nor biopsy studies are available to elucidate the nature of the enlargement.

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