BACKGROUND:

Paraneoplastic syndromes are distant manifestations of neoplasms originated by secondary mechanisms but not by tumor invasion. They are infrequent, precede the manifestation of the tumor itself and disappear when the tumor is cured. Although myasthenia gravis has traditionally been related to thymomas, here we report a case of myasthenia gravis as a paraneoplastic syndrome of an ovarian tumor and review the available literature on its diagnosis.

CLINICAL CASE:

46-year-old patient with multiple episodes of generalized weakness and ventilatory failure requiring mechanical ventilation and intensive care stay. The clinical diagnosis of myasthenia gravis was established. Despite adequate treatment and thymectomy, the crises persisted. Soon after, she was diagnosed with serous adenocarcinoma of the ovary, which was treated with surgery and chemotherapy. With this, the neurological symptoms disappeared, with total remission after four years of follow-up, without medical treatment. For the literature review a search was undertaken in Medline, Cochrane, LILACS, Google Scholar and grey literature with the terms "myasthenia gravis AND ovarian cancer". Eighteen articles were found of which only two publications were included for the full review.

CONCLUSIONS:

Neurological syndromes, among this myasthenia gravis, associated with ovarian tumors as paraneoplastic syndromes are rare and raise the need to include gynecological study in patients with myasthenia gravis of atypical manifestation.

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