title: The great masquerader of malignancy: chronic intestinal pseudo-obstruction.
abstract: Paraneoplastic syndromes can precede the initial manifestation and diagnosis of cancer. Paraneoplastic syndromes are a heterogeneous group of disorders caused by mechanisms other than the local presence of tumor cells. These phenomena are mediated by humoral factors secreted by tumor cells or by tumor mediated immune responses. Among paraneoplastic syndromes, chronic intestinal pseudo-obstruction (CIPO) is rare and represents a particularly difficult clinical challenge. Paraneoplastic CIPO is a highly morbid syndrome characterized by impaired gastrointestinal propulsion with symptoms and signs of mechanical bowel obstruction. Clinical outcomes of paraneoplastic CIPO are often deleterious. The current standard of care for the management of CIPO includes supportive treatment with promotility and anti-secretory agents. However, the majority of patients with CIPO eventually require the resection of the non-functioning gut segment. Here, we present a 62-year-old patient with anti-Hu antibody associated paraneoplastic CIPO and underlying small cell lung cancer who underwent treatment with cisplatin and etoposide. Herein, we discuss diagnosis, prognosis, proposed mechanisms, treatment options, and future potential therapeutic strategies of paraneoplastic CIPO.
authors: Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723 USA ; Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, 1515 N Campbell Ave, Tucson, AZ 85724 USA ; University of Arizona College of Medicine, 1501 N. Campbell Ave, Tucson, AZ 85724 USA ; Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Ave, Rm 6336, Tucson, AZ 85724 USA.
authors: Josephine A
authors: JA
authors: Taverna
authors: Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723 USA ; Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, 1515 N Campbell Ave, Tucson, AZ 85724 USA ; University of Arizona College of Medicine, 1501 N. Campbell Ave, Tucson, AZ 85724 USA ; Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Ave, Rm 6336, Tucson, AZ 85724 USA.
authors: Hani M
authors: HM
authors: Babiker
authors: Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723 USA ; Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, 1515 N Campbell Ave, Tucson, AZ 85724 USA ; University of Arizona College of Medicine, 1501 N. Campbell Ave, Tucson, AZ 85724 USA ; Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Ave, Rm 6336, Tucson, AZ 85724 USA.
authors: Seongseok
authors: S
authors: Yun
authors: Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723 USA ; Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, 1515 N Campbell Ave, Tucson, AZ 85724 USA ; University of Arizona College of Medicine, 1501 N. Campbell Ave, Tucson, AZ 85724 USA ; Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Ave, Rm 6336, Tucson, AZ 85724 USA.
authors: Maria C
authors: MC
authors: Bishop
authors: University of Arizona College of Medicine, 1501 N. Campbell Ave, Tucson, AZ 85724 USA.
authors: Sarah
authors: S
authors: Lau-Braunhut
authors: Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723 USA.
authors: Paul N
authors: PN
authors: Meyer
authors: Division of Hematology-Oncology, Department of Medicine, Southern Arizona VA Health Care System, 3601 S 6Th Ave, Tucson, AZ 85723 USA ; Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, 1515 N Campbell Ave, Tucson, AZ 85724 USA ; University of Arizona College of Medicine, 1501 N. Campbell Ave, Tucson, AZ 85724 USA ; Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Ave, Rm 6336, Tucson, AZ 85724 USA.
authors: Thomas
authors: T
authors: Enzler
keywords: Anti-Hu antibodies; Myenteric ganglioneuritis; Paraneoplastic chronic intestinal pseudo-obstruction; Small cell lung cancer
references: Brain. 2001 Jun;124(Pt 6):1138-48
references: 11353730
references: Am J Gastroenterol. 2001 Feb;96(2):373-9
references: 11232678
references: Neurology. 1990 Oct;40(10):1621-3
references: 2215957
references: Clin Sci (Lond). 2002 May;102(5):475-86
references: 11980564
references: Lancet. 1999 Jan 9;353(9147):117-8
references: 10023900
references: N Engl J Med. 2003 Oct 16;349(16):1543-54
references: 14561798
references: Dig Dis Sci. 1989 Dec;34(12):1937-42
references: 2557192
references: Gut. 2004 Nov;53(11):1549-52
references: 15479666
references: Pract Neurol. 2007 Oct;7(5):336-41
references: 17885274
references: Medicine (Baltimore). 1992 Mar;71(2):59-72
references: 1312211
references: Isr Med Assoc J. 2001 Feb;3(2):94-103
references: 11344832
references: BMJ Case Rep. 2010 Oct 03;2010:null
references: 22802230
references: Lung Cancer. 2005 Apr;48(1):137-40
references: 15777981
references: Lancet. 1993 Jan 2;341(8836):21-2
references: 8093269
references: Oncoimmunology. 2013 Dec 1;2(12):e27384
references: 24501693
references: J Neurooncol. 2009 Jul;93(3):421-3
references: 19139820
references: Clin Oncol (R Coll Radiol). 2004 Feb;16(1):71-6
references: 14768759
references: Gastroenterology. 1991 Jan;100(1):137-42
references: 1845756
references: Support Care Cancer. 2012 Feb;20(2):425-8
references: 22072051
references: Clin Transl Oncol. 2006 Nov;8(11):796-801
references: 17134967
references: Neurology. 2004 Nov 23;63(10):1947-9
references: 15557520
references: Orphanet J Rare Dis. 2007 May 04;2:22
references: 17480225
references: World J Gastroenterol. 2008 May 21;14(19):2953-61
references: 18494042
references: Gastroenterology. 2004 Jun;126(7):1872-83
references: 15188182
references: Aliment Pharmacol Ther. 2008 Jul;28(1):25-42
references: 18410560
references: Neurology. 1992 Mar;42(3 Pt 1):536-40
references: 1312683
references: Dis Colon Rectum. 1986 Mar;29(3):203-10
references: 3753674
references: J Clin Oncol. 1997 Aug;15(8):2866-72
references: 9256130
references: Lupus. 2013 Aug;22(9):957-60
references: 23761180
references: Neurology. 1998 Oct;51(4):1146-50
references: 9781545