title: Paraneoplastic neurological syndrome as an initial indicator of small cell carcinoma of the lung.
abstract: Paraneoplastic syndromes are indirect manifestations of cancer due to functional peptides/hormones produced by a tumour, or due to cross reactivity between tumour and host antigens. Here the case of a 58-year-old woman presenting with ataxia, paraesthesia and subacute and progressive loss of vision is reported. The patient exhibited strong serum positivity for anti-Hu and anti-CV2 antibodies, and a chest CT scan showed a hypodense nodule in proximity of the right upper lobe bronchus and an enlarged ipsilateral paratracheal lymph node that was not visible on a lung x-ray. Histopathological examination of a biopsy specimen from this lymph node showed that small cell carcinoma of the lung was present. The patient's deficits were subsequently diagnosed as three coexisting paraneoplastic neurological syndromes (PNSs): subacute cerebellar ataxia, sensory neuropathy and retinopathy, respectively. Although rare, PNSs can be the first manifestations of cancer, and their rapid recognition facilitates an early treatment.
authors: Internal Medicine Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal. leneaporto@gmail.com
authors: Lénea
authors: L
authors: Porto
authors: Mafalda
authors: M
authors: Miranda
authors: Ana
authors: A
authors: Gomes
authors: Rui
authors: R
authors: André
authors: Bárbara
authors: B
authors: Rodrigues
mesh_terms: D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000276:immunology; D008875:Middle Aged; D020362:Paraneoplastic Cerebellar Degeneration / Q000209:etiology / Q000276:immunology; D020364:Paraneoplastic Polyneuropathy / Q000209:etiology / Q000276:immunology; D020361:Paraneoplastic Syndromes, Nervous System / Q000209:etiology* / Q000276:immunology; D059545:Paraneoplastic Syndromes, Ocular / Q000209:etiology* / Q000276:immunology; D055752:Small Cell Lung Carcinoma / Q000150:complications* / Q000276:immunology
references: Eur J Neurol. 2006 Jul;13(7):682-90
references: 16834698
references: J Neurol Neurosurg Psychiatry. 2004 Aug;75(8):1135-40
references: 15258215
references: J Neurol Neurosurg Psychiatry. 1991 Sep;54(9):764-7
references: 1659614
references: N Engl J Med. 1987 Dec 17;317(25):1598-600
references: 3479684
references: J Neurol Sci. 2001 Mar 1;184(2):131-7
references: 11239946
references: Mayo Clin Proc. 2010 Sep;85(9):838-54
references: 20810794
references: Orphanet J Rare Dis. 2007 May 04;2:22
references: 17480225
references: J Neurol Neurosurg Psychiatry. 2010 Jan;81(1):42-5
references: 19324868
references: J Neuroimmunol. 2004 Oct;155(1-2):150-4
references: 15342206
references: N Engl J Med. 2003 Oct 16;349(16):1543-54
references: 14561798
references: Brain. 1997 Aug;120 ( Pt 8):1279-300
references: 9278623
references: An Med Interna. 2001 Aug;18(8):440-6
references: 11589085
references: Aust N Z J Med. 1991 Apr;21(2):227-9
references: 1872750