[Sensorimotor polyneuropathy and systemic amyloidosis as paraneoplastic symptoms of a carcinoid-like well differentiated carcinoma of the breast].
METHODS
A 75-year-old woman was admitted because of weakness and paraesthesias in both legs. 15 years earlier a chest radiogram had shown numerous round foci of uncertain cause. Physical examination confirmed muscular weakness in all limbs, especially the legs, as well as abnormal superficial and deep sensory perception.


METHODS
Electromyography registered a patchy pattern of intentional muscular activity and marked denervation activity but largely normal nerve conduction. There was no evidence of inflammatory disease in the laboratory tests, including the CNS. DIAGNOSIS, COURSE AND TREATMENT: The neurological findings indicated progressive axonal sensorimotor polyneuropathy. A paraneoplastic cause was suspected, but search for a primary tumour was unsuccessful. The patient developed a urinary infection from which she died in septic shock. A carcinoid-like well-differentiated carcinoma of the breast with hematogenous metastases to liver, spleen and lung was discovered at autopsy. It also revealed severe systemic AA-type amyloidosis, involving liver, spleen heart and kidneys. In addition there was a severe progressive axonal neuropathy and marked neurogenic atrophy of the peripheral skeletal musculature. No amyloid deposition was seen.


CONCLUSIONS
In case of amyloidosis and polyneuropathy of uncertain cause a paraneoplastic pathogenesis should be considered in the differential diagnosis, even in the absence of proven malignancy.
Krüger
S
S
Institut für Pathologie, Medizinischen Universität zu Lübeck.
Kreft
B
B
Heide
W
W
Siebel
U
U
Djonlagic
H
H
Reusche
E
E
D000368:Aged; D000686:Amyloidosis / Q000209:etiology*; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology*; D018394:CA-125 Antigen / Q000032:analysis; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000473:pathology* / Q000556:secondary; D004576:Electromyography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D018908:Muscle Weakness / Q000209:etiology*; D010292:Paresthesia / Q000209:etiology*; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D013160:Splenic Neoplasms / Q000556:secondary
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen
Sensomotorische Polyneuropathie und systemische Amyloidose als paraneoplastische Symptome eines karzinoidartig differenzierten Mammakarzinoms.