title: Neuromyelitis optica spectrum disorder as a paraneoplastic manifestation of lung adenocarcinoma expressing aquaporin-4.
abstract: BACKGROUND
  The observations of neuromyelitis optica spectrum disorders (NMOSD) occurring in the setting of cancer suggest that aquaporin-4 (AQP4) autoimmunity may in some cases be paraneoplastic.
  
  
  RESULTS
  We describe a 72-year-old patient who developed a longitudinally extensive transverse myelitis associated with AQP4 autoantibodies in the setting of a lung adenocarcinoma recurrence. AQP4 expression was demonstrated in tumor cells. IgG in patient's cerebrospinal fluid bound to tumor cells co-localizing with AQP4 immunoreactivity.
  
  
  CONCLUSIONS
  This case expands the spectrum of paraneoplastic AQP4 autoimmunity highlighting the importance of considering an oncological screening in patients with late-onset NMOSD.
authors.affiliation: Institute of Neurology, Catholic University, Rome, Italy iorio.raffaele@gmail.com.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Iorio
authors.affiliation: Institute of Anatomic Pathology, Catholic University, Rome, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Rindi
authors.affiliation: Institute of Neurology, Catholic University, Rome, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Erra
authors.affiliation: Institute of Neurology, Catholic University, Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Damato
authors.affiliation: Institute of Neurology, Catholic University, Rome, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Ferilli
authors.affiliation: Institute of Neurology, Catholic University, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Sabatelli
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D000077192:Adenocarcinoma of Lung; D000368:Aged; D051401:Aquaporin 4 / Q000276:immunology / Q000378:metabolism; D001323:Autoantibodies; D006801:Humans; D008175:Lung Neoplasms / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008297:Male; D009188:Myelitis, Transverse / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000378:metabolism / Q000473:pathology
chemical_list: D051401:Aquaporin 4; D001323:Autoantibodies
keywords: Paraneoplastic; neuromyelitis optica