title: Large cell neuroendocrine carcinoma of the lung with cancer-associated retinopathy.
abstract: We report a rare case of large cell neuroendocrine carcinoma (LCNEC) of the lung with cancer-associated retinopathy (CAR). To our knowledge, only two cases of LCNEC with CAR have been reported, one in 1995 and another in 2013. CAR, typically associated with small cell lung cancer (SCLC), is one of the paraneoplastic syndromes with deterioration of visual acuity, visual field constriction, and photophobia. CAR is caused by an autoimmune system reaction against the same antigen in the tumor and retinal photoreceptor cells. To diagnose CAR, genetic retinal dystrophies or any other medical causes of retinopathy should be excluded, but there are no standard diagnostic criteria. Anti-retinal antibodies are known to be positive in CAR patients, and anti-recoverin antibodies are thought to be sensitive and specific to CAR. In our case, anti-recoverin antibodies were not detected by serum tests, but CAR could be diagnosed on the basis of ophthalmological findings including clinical symptoms, electroretinographic findings, and visual field tests. CAR with clinical features of rapid visual disorder should be considered in LCNEC patients as well as in SCLC patients.
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Takahiko
authors: T
authors: Nakamura
authors: Department of Clinical Research Center, Osaka Medical College Hospital, Osaka, Japan ; Department of Cancer Center, Osaka Medical College Hospital, Osaka, Japan.
authors: Yasuhito
authors: Y
authors: Fujisaka
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Yosuke
authors: Y
authors: Tamura
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Hiroyuki
authors: H
authors: Tsuji
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Ninso
authors: N
authors: Matsunaga
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Shuhei
authors: S
authors: Yoshida
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Masafumi
authors: M
authors: Imanishi
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Kazuhiko
authors: K
authors: Fujita
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Soichiro
authors: S
authors: Ikeda
authors: Department of Ophthalmology, Osaka Medical College, Osaka Medical College Hospital, Osaka, Japan.
authors: Hidehiro
authors: H
authors: Oku
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Isao
authors: I
authors: Goto
authors: Department of Ophthalmology, Osaka Medical College, Osaka Medical College Hospital, Osaka, Japan.
authors: Tsunehiko
authors: T
authors: Ikeda
authors: Department of Internal Medicine (I), Osaka Medical College Hospital, Osaka, Japan.
authors: Toshiaki
authors: T
authors: Hanafusa
keywords: Anti-recoverin antibodies; Cancer-associated retinopathy; Large cell neuroendocrine carcinoma