Paraneoplastic fasciitis-panniculitis syndrome: a neurological point of view.
BACKGROUND
A 54-year-old woman who had undergone gastrectomy to treat gastric adenocarcinoma 5 years previously and had since been in remission presented to a neuromuscular clinic complaining of stiffening and painful spasms of the legs and abdomen. Repeat pan-CT scans and gastric biopsy confirmed the recurrence of poorly differentiated signet ring gastric adenocarcinoma. Her symptoms improved remarkably on initiation of chemotherapy and worsened on discontinuation of chemotherapy.


METHODS
Neurological examination, MRI of the abdomen and lower extremities, whole-body fluorodeoxyglucose PET, pan-CT scan, electromyography, muscle biopsy, upper gastrointestinal tract radiography, esophagogastroduodenoscopy, and immunophenotyping (paraneoplastic, rheumatological and autoimmune diseases panels).


METHODS
Paraneoplastic fasciitis-panniculitis syndrome associated with the recurrence of poorly differentiated signet ring gastric adenocarcinoma.


RESULTS
Chemotherapy of recurrent gastric adenocarcinoma and symptomatic management of painful spasms.
Dinakar
Pradeep
P
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Pain Management Center, Chestnut Hill, MA 02467, USA. pdinakar@partners.org
Höke
Ahmet
A
D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D015434:Panniculitis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D010257:Paraneoplastic Syndromes / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D049268:Positron-Emission Tomography; D013274:Stomach Neoplasms / Q000601:surgery; D014057:Tomography, X-Ray Computed