[Difficulties associated with Lambert-Eaton syndrome].
BACKGROUND
The diagnosis and treatment of the neurological paraneoplastic syndromes associated with lung cancer can pose a challenge both to general physicians and neurologists as well as pulmonologists.


METHODS
A 53 year-old heavy smoker presented with a Lambert-Eaton myasthenic syndrome (LEMS). Bronchoscopy was normal but radiological examinations revealed a lymph node in site 4R. The pathological diagnosis after mediastinoscopy was negative. Twenty-five months later, an opacity on chest X-ray led to a biopsy which revealed a squamous cell carcinoma. A lobectomy was performed for a pT2N0M0 lesion. A significant improvement of neurological symptoms was seen. The myasthenic syndrome reappeared 21 months later. A local and general relapse was diagnosed. The patient died 10 months later despite chemotherapy.


CONCLUSIONS
LEMS occurs because of an immunological reaction against voltage-dependent calcium channels. LEMS is generally associated with small cell lung cancer occurring in three percent of cases. However, the case that we report shows the unusual association of LEMS with non small-cell lung cancer and highlights the difficulties associated in the management of this condition.
Tchouhadjian
C
C
Service d'Oncologie Thoracique, Département des Maladies Respiratoires, Hôpital Sainte Marguerite, Marseille, France.
Barlesi
F
F
Doddoli
C
C
Escarguel
B
B
Thomas
P
P
Witjas
T
T
Astoul
P
P
Kleisbauer
J P
JP
D017809:Fatal Outcome; D006801:Humans; D015624:Lambert-Eaton Myasthenic Syndrome / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence