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Small-cell lung cancer: a case report on the manifestation of paraneoplastic motor neuron disease after effective tumor shrinkage during chemotherapy

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Abstract

A 72-year-old Japanese man with locally advanced small-cell lung cancer presented with gait disturbance, caused by weakness in both lower extremities; this occurred during chemotherapy that effectively reduced the size of his tumor. Muscle weakness was severe in the bilateral proximal upper extremities, and moderate in the bilateral distal upper extremities and the bilateral lower limbs. Numbness and mild hypoesthesia were also present in the right upper and lower extremities. Involvement of brain and spinal lesions were an unlikely cause of these symptoms. Findings from a nerve conduction study suggested a mild peripheral sensory neuropathy complication. The patient died of respiratory failure and CO2 narcosis at 9 months after the diagnosis of malignancy and at 4 months after the first manifestation of muscular weakness. Anti-Hu antibody was reported to be positive after his death. Thus, paraneoplastic motor neuron disease (MND) was definitely confirmed. In conclusion, this was a rare case of paraneoplastic MND; the clinical course was uncommon in that the MND occurred when chemotherapy had successfully reduced the size of the tumor.

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References

  1. Giometto B, Grisold W, Vitaliani R et al (2010) Paraneoplastic neurologic syndrome in the PNS Euronetwork database: a European study from 20 centers. Arch Neurol 67:330–335

    Article  PubMed  Google Scholar 

  2. Elrington GM, Murray NM, Spiro SG et al (1991) Neurological paraneoplastic syndromes in patients with small cell lung cancer. A prospective survey of 150 patients. J Neurol Neurosurg Psychiatry 54:764–767

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  3. Rudnicki SA, Dalmau J (2000) Paraneoplastic syndromes of the spinal cord, nerve, and muscle. Muscle Nerve 23:1800–1818

    Article  PubMed  CAS  Google Scholar 

  4. Fang F, Al-Chalabi A, Ronnevi LO et al (2013) Amyotrophic lateral sclerosis and cancer: a register-based study in Sweden. Amyotroph Lateral Scler Frontotemporal Degener 14:362–368

    Article  PubMed  Google Scholar 

  5. Forsyth PA, Dalmau J, Graus F et al (1997) Motor neuron syndromes in cancer patients. Ann Neurol 41:722–730

    Article  PubMed  CAS  Google Scholar 

  6. Graus F, Delattre JY, Antoine JC et al (2004) Recommended diagnostic criteria for paraneoplastic neurological syndromes. J Neurol Neurosurg Psychiatry 75:1135–1140

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  7. Camdessanche JP, Antoine JC, Honnorat J et al (2002) Paraneoplastic peripheral neuropathy associated with anti-Hu antibodies. A clinical and electrophysiological study of 20 patients. Brain 125:166–175

    Article  PubMed  Google Scholar 

  8. Sillevis Smitt P, Grefkens J, de Leeuw B et al (2002) Survival and outcome in 73 anti-Hu positive patients with paraneoplastic encephalomyelitis/sensory neuronopathy. J Neurol 249:745–753

    Article  PubMed  Google Scholar 

  9. Ishizuka H, Kudo M (1990) Immunoreactive myelin basic protein in tumor cells in a patient with amyotrophic lateral sclerosis and ovarian carcinoma: a clinicopathological report. Toho Igakukai Zasshi 37:121–127

    Google Scholar 

  10. Kogashiwa Y, Oishi N, Yamauchi K et al (2011) Advanced hypopharyngeal cancer with amyotrophic lateral sclerosis. Auris Nasus Larynx 38:750–752

    Article  PubMed  Google Scholar 

  11. Koshiba M, Kajita H, Yamashita M et al (1991) An autopsy case of hepatocellular carcinoma with liver cirrhosis, combined with amyotrophic lateral sclerosis. Naika Hokan 36:95–99

    Google Scholar 

  12. Sato Y, Takayama T, Nikaido T et al (2007) Report of an autopsy case of colon cancer with amyotrophic lateral sclerosis. Nihon Shokakibyo Gakkai Zasshi 104:1365–1370

    PubMed  Google Scholar 

  13. Sekiguchi K, Shirafuji T, Kanda F et al (2007) An acute reduction of amplitudes of compound muscle action potential and abundant fasciculation in patient with limbic encephalitis associated with anti-Hu antibody. Rinshyo Noha 49:531–535

    Google Scholar 

  14. Ducray F, Graus F, Vigliani MC et al (2010) Delayed onset of a second paraneoplastic neurological syndrome in eight patients. J Neurol Neurosurg Psychiatry 81:937–939

    Article  PubMed  Google Scholar 

  15. Mitchell DM, Olczak SA (1979) Remission of a syndrome indistinguishable from motor neurone disease after resection of bronchial carcinoma. Br Med J 2:176–177

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  16. Peacock A, Dawkins K, Rushworth G (1979) Motor neurone disease associated with bronchial carcinoma? Br Med J 2:499–500

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  17. Tofaris GK, Farmer SF (2008) Focal paraneoplastic syndrome associated with small cell carcinoma of the lung. J Neurol 255:123–124

    Article  PubMed  Google Scholar 

  18. Verma A, Berger JR, Snodgrass S et al (1996) Motor neuron disease: a paraneoplastic process associated with anti-Hu antibody and small-cell lung carcinoma. Ann Neurol 40:112–116

    Article  PubMed  CAS  Google Scholar 

  19. Honnorat J, Antoine JC (2007) Paraneoplastic neurological syndromes. Orphanet J Rare Dis 2:22

    Article  PubMed  PubMed Central  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Seigo Minami.

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S. Minami, T. Okazaki and M. Hamaguchi have contributed equally to this report.

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Minami, S., Okazaki, T., Hamaguchi, M. et al. Small-cell lung cancer: a case report on the manifestation of paraneoplastic motor neuron disease after effective tumor shrinkage during chemotherapy. Int Canc Conf J 3, 247–251 (2014). https://doi.org/10.1007/s13691-014-0156-8

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  • DOI: https://doi.org/10.1007/s13691-014-0156-8

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