[Malignant thymoma with myasthenia gravis and hepatic metastasis. Report of a case and review of the literature]. / Timoma maligno con miastenia gravis y metástasis hepáticas. Presentación de un caso y revisión de la literatura.

This paper reports a case of an histological non aggressive thymoma with myasthenic symptoms as the first clinical manifestation. Three years after its complete surgical resection liver metastases appeared without evidence of intrathoracic neoplastic disease. The extrathoracic metastases are uncommon and the thymomatous myasthenia gravis is present in 25 to 50% of cases. We reviewed the literature and analyzed its clinical pathological characteristics and therapeutics approach.

[Gallbladder contraction in patients with asymptomatic cholelithiasis]. / Estudio de la contracción vesicular en pacientes con colelitiasis asintomática.

There are many discrepancies between reports about gallbladder motility in gallstones disease. We studied gallbladder volume and contraction in 65 patients with asymptomatic gallstones and compared with 65 healthy controls by ultrasonography. The mass of the stones was less of the 25% of the gallbladder volume. We related stone size and number with its motor function. The results of the gallbladder contraction (GC) in the control group was 79.5% (DS = 9.5) and in the cholelithiasis group was 59.9% (DS = 19) with (p < 0.01). We found that the cholelithiasis group was heterogeneous and on closer inspection the patients fell into two subgroups separated by the inferior limit of normal GC (60%). The subgroup I (41 patients) had a fasting volume (FV) of 26.6 ml (DS = 14.1), a postprandial volume (PV) of 6.5 ml (DS = 3.8) and a GC of 75.3% (DS = 8.5). The subgroup II (24 patients) had a FV of 27.3 ml (DS = 20.3), a PV of 16.9 ml (DS = 15) and a GC of 40.5% (DS = 11.8). There was significant differences in PV and GC (p < 0.01). We concluded that defective gallbladder emptying is evident in a subgroup of patients but gallbladder contraction may be normal in patients with cholelithiasis and there are, not correlation between GC and the number and size of the stones.