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BACKGROUND: Thymoma is a T cell neoplasm arising from the thymic epithelium that \uddue to its immunological role, frequently undercover derangements of immunity\udsuch a tumors and autoimmune diseases.\udMETHODS: Herein, we report, to the best of our knowledge, the first description\udof an association between thymoma and adult onset Still disease (AOSD) in a\ud47-year-old man. The first one was occasionally detected 4 years later the\uddiagnosis of AOSD, and surgically removed via right lateral thoracotomy.\udHistology confirmed an encapsulated thymic tumor (type AB sec.\udWHO-classification).\udRESULTS: The AOSD was particularly resistant to the therapy, requiring a\udcombination of immunosuppressant followed by anti-IL1R, that was the only\udsteroids-sparing treatment capable to induce and maintain the remission. The\uddifferential diagnosis was particularly challenging because of the severe\udmyasthenic-like symptoms that, with normal laboratory tests, were initially\udmisinterpreted as fibromyalgia. The pathogenic link of this association could be \uda thymus escape of autoreactive T lymphocytes causing autoimmunity.\udCONCLUSION: Clinicians should be always include the possibility of a thymoma in\udthe differential diagnosis of an unusual new onset of weakness and normal\udlaboratories data, in particular once autoimmune disease is present in the\udmedical history

Occasional detection of thymic epithelial tumor 4 years after diagnosis of adult onset Still disease