A Case of Small Cell Lung Cancer with Diverse Neurological Symptoms due to Paraneoplastic Neurological Syndrome

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  • Yamago Taito
    Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School Department of Internal Medicine, JA Kochi Hospital
  • Hanibuchi Masaki
    Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Ogino Hirokazu
    Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Murakami Nagahisa
    Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Kaji Ryuji
    Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School
  • Nishioka Yasuhiko
    Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School

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Other Title
  • 多彩な神経症状を呈した小細胞肺癌に伴う傍腫瘍性神経症候群の1例

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Description

Background. Paraneoplastic neurological syndrome is a neurological disorder associated with various malignancies and is considered to be caused by autoimmune mechanisms, but not by symptoms due to tumor progression itself. Small cell lung cancer is the most common type of malignancy accompanied with paraneoplastic neurological syndrome. Case. A 77-year-old male was referred to our hospital for further examination of general fatigue, gait disturbance and dysuria. On admission, diverse neurological symptoms, such as dysarthria, dysphagia, motor and sensory disturbance in lower extremities and autonomic dysregulation, were observed. Further examination yielded the diagnosis of Lambert-Eaton myasthenic syndrome with positive results for anti-amphiphysin and anti-ganglioside antibodies. Swelling of the mediastinal lymph nodes and elevated ProGRP were detected, and a definitive diagnosis of small cell lung cancer (cTXN2M1b: Stage IV) was made. As the administration of intravenous immunoglobulin failed to ameliorate his neurological symptoms and general condition (PS 4), we determined that there were no indications for chemotherapy. He was subsequently transferred to a palliative care hospital and died nearly one year after the development of his initial symptoms. Conclusion. We experienced a case of small cell lung cancer with diverse neurological symptoms due to the presence of paraneoplastic neurological syndrome.

Journal

  • Haigan

    Haigan 56 (3), 199-204, 2016

    The Japan Lung Cancer Society

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